Prognostic value and time course evolution left ventricular global longitudinal strain in septic shock: an...

Area of Science:

• Cardiology
• Intensive Care Medicine
• Echocardiography

Background:

• Septic shock often leads to myocardial dysfunction.
• Global longitudinal strain (GLS) is a sensitive marker of myocardial function.
• Understanding GLS dynamics in early septic shock is crucial for patient management.

Purpose of the Study:

• To describe the course of GLS during the initial days of septic shock.
• To assess the agreement between GLS and longitudinal strain in the apical four-chamber view (LS4C).

Main Methods:

• Prospective observational study at Nimes University Hospital's ICU.
• Included patients with septic shock and no pre-existing heart disease.
• Echocardiography (LVEF and GLS) performed on days 1, 3-5, and 6-8.

Main Results:

• GLS was impaired at T1 (-11.0%).
• Significant GLS improvement observed by T2 (-11% vs -16%, p=0.02), while LVEF remained stable.
• Good agreement found between GLS and LS4C measurements (Bland-Altman mean difference: 0.1).

Conclusions:

• Myocardial strain is depressed in the early phase of septic shock and improves over time.
• LS4C measurements show good agreement with GLS and appear sufficient for bedside assessment.