Global Longitudinal Strain Using Speckle-Tracking Echocardiography as a Mortality Predictor in Sepsis: A Systematic Review

Author:

Vallabhajosyula Saraschandra12ORCID,Rayes Hamza A.2,Sakhuja Ankit2,Murad Mohammad Hassan34,Geske Jeffrey B.1,Jentzer Jacob C.12

Affiliation:

1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA

3. Division of Preventive, Occupational and Aerospace Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA

4. Division of Health Science Research, Robert D. and Patricia E. Kern Center for Health Care Delivery, Mayo Clinic, Rochester, MN, USA

Abstract

The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate. A total of 120 studies were identified, with 5 studies (561 patients) included in the final analysis. All studies were prospective observational studies using the 2001 criteria for defining sepsis. Three studies demonstrated worse systolic GLS to be associated with higher mortality, whereas 2 did not show a statistically significant association. Various cutoffs between −10% and −17% were used to define abnormal GLS across studies. This systematic review revealed that STE may predict mortality in patients with sepsis; however, the strength of evidence is low due to heterogeneity in study populations, GLS technologies, cutoffs, and timing of STE. Further dedicated studies are needed to understand the optimal application of STE in patients with sepsis.

Publisher

SAGE Publications

Subject

Critical Care and Intensive Care Medicine

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