BACKGROUND:Septic cardiomyopathy(SCM)occurs in the early stage of sepsis and septic shock,which has implications for treatment strategies and prognosis.Additionally,myocardial involvement in the early stages of sepsis is difficult to identify.Here,we assess subclinical myocardial function using laboratory tests and speckle-tracking echocardiography(STE).METHODS:Emergency department patients diagnosed with sepsis or septic shock were included for analysis.Those with other causes of acute or pre-existing cardiac dysfunction were excluded.Transthoracic echocardiography(TTE),including conventional echocardiography and STE,were performed for all patients three hours after initial resuscitation.Samples for laboratory tests were taken around the time of TTE.RESULTS:Left ventricular functions of 60 patients were analyzed,including 21 septic shock patients and 39 sepsis patients.There was no significant difference in global longitudinal strain(GLS),global circumferential strain(GCS),or global radical strain(GRS)between patients with sepsis and septic shock(all with P＞0.05).However,GLS and GCS were significantly less negative in patients with abnormal troponin levels or in patients with abnormal left ventricular ejection fraction(LVEF)values(all with P＜0.05).There were also moderate correlations between GLS and levels of cTnl(r=0.40,P=0.002)or N-terminal pro-B-type natriuretic peptide(NT-proBNP)(r=0.44,P=0.001)in sepsis and septic shock patients.CONCLUSION:Myocardial dysfunction,e.g.,lower LVEF or less negative GLS in patients with sepsis or septic shock,is more affected by myocardial injury.GLS could be incorporated into mainstream clinical practice as a supplementary LVEF parameter,especially for those with elevated troponin levels.

Xuan Fu;Xue Lin;Samuel Seery;Li-na Zhao;Hua-dong Zhu;Jun Xu;Xue-zhong Yu

Emergency Department,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China;Department of Cardiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Faculty of Health and Medicine,Division of Health Research,Lancaster University,Lancaster LA1 4YW,United Kingdom

世界急诊医学杂志（英文）

[1]Xuan Fu;Xue Lin;Samuel Seery;Li-na Zhao;Hua-dong Zhu;Jun Xu;Xue-zhong Yu-.Speckle-tracking echocardiography for detecting myocardial dysfunction in sepsis and septic shock patients:A single emergency department study)[J].世界急诊医学杂志（英文）,2022(03):175-181

Transthoracic

Speckle,tracking,echocardiography,detecting,myocardial,dysfunction,sepsis,septic,shock,patients,single,emergency,department,study,BACKGROUND,Septic,cardiomyopathy,SCM,occurs,early,which,has,implications,treatment,strategies,prognosis,Additionally,involvement,stages,difficult,identify,Here,assess,subclinical,using,laboratory,tests,speckle,STE,METHODS,Emergency,diagnosed,were,included,analysis,Those,other,causes,acute,pre,existing,cardiac,excluded,TTE,including,conventional,performed,three,hours,after,initial,resuscitation,Samples,taken,around,RESULTS,Left,ventricular,functions,analyzed,There,was,difference,global,longitudinal,strain,GLS,circumferential,GCS,radical,GRS,between,However,significantly,less,negative,abnormal,troponin,levels,left,ejection,fraction,LVEF,values,also,moderate,correlations,cTnl,terminal,type,natriuretic,peptide,NT,proBNP,CONCLUSION,Myocardial,lower,more,affected,by,injury,could,incorporated,into,mainstream,practice,supplementary,parameter,especially,those,elevated

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