Left ventricular longitudinal wall fractional shortening accurately predicts longitudinal strain in critically ill patients with septic shock
(2021) In Annals of Intensive Care 11(1).- Abstract
Background: Left ventricular longitudinal strain (LVLS) may be a sensitive indicator of left ventricular (LV) systolic function in patients with sepsis, but is dependent on high image quality and analysis software. Mitral annular plane systolic excursion (MAPSE) and the novel left ventricular longitudinal wall fractional shortening (LV-LWFS) are bedside echocardiographic indicators of LV systolic function that are less dependent on image quality. Both are sparsely investigated in the critically ill population, and may potentially be used as surrogates for LVLS. We assessed if LVLS may be predicted by LV-LWFS and MAPSE in patients with septic shock. We also assessed the repeatability and inter-rater agreement of LVLS, LV-LWFS and MAPSE... (More)
Background: Left ventricular longitudinal strain (LVLS) may be a sensitive indicator of left ventricular (LV) systolic function in patients with sepsis, but is dependent on high image quality and analysis software. Mitral annular plane systolic excursion (MAPSE) and the novel left ventricular longitudinal wall fractional shortening (LV-LWFS) are bedside echocardiographic indicators of LV systolic function that are less dependent on image quality. Both are sparsely investigated in the critically ill population, and may potentially be used as surrogates for LVLS. We assessed if LVLS may be predicted by LV-LWFS and MAPSE in patients with septic shock. We also assessed the repeatability and inter-rater agreement of LVLS, LV-LWFS and MAPSE measurements. Results: 122 TTE studies from 3 echocardiographic data repositories of patients admitted to ICU with septic shock were retrospectively assessed, of which 73 were suitable for LVLS analysis using speckle tracking. The correlations between LVLS vs. LV-LWFS and LVLS vs. MAPSE were 0.89 (p < 0.001) and 0.81 (p < 0.001) with mean squared errors of 5.8% and 9.1%, respectively. Using the generated regression equation, LV-LWFS predicted LVLS with a high degree of accuracy and precision, with bias and limits of agreement of -0.044 ± 4.7% and mean squared prediction error of 5.8%. Interobserver repeatability was good, with high intraclass correlation coefficients (0.96–0.97), small bias and tight limits of agreement (≤ 4.1% for all analyses) between observers for all measurements. Conclusions: LV-LWFS may be used to estimate LVLS in patients with septic shock. MAPSE also performed well, but was slightly inferior compared to LV-LWFS in estimating LVLS. Feasibility of MAPSE and LV-LWFS was excellent, as was interobserver repeatability.
(Less)
- author
- Johansson Blixt, Patrik ; Chew, Michelle S. LU ; Åhman, Rasmus ; de Geer, Lina ; Blomqwist, Lill LU ; Åström Aneq, Meriam ; Engvall, Jan and Andersson, Henrik
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Fractional shortening, Left ventricle, MAPSE, Sepsis, Strain, Systolic function
- in
- Annals of Intensive Care
- volume
- 11
- issue
- 1
- article number
- 52
- publisher
- Springer
- external identifiers
-
- pmid:33782770
- scopus:85103406044
- ISSN
- 2110-5820
- DOI
- 10.1186/s13613-021-00840-6
- language
- English
- LU publication?
- no
- id
- d0f1ee43-474e-4098-843b-90209146c4dd
- date added to LUP
- 2021-04-12 08:31:10
- date last changed
- 2024-04-20 04:42:37
@article{d0f1ee43-474e-4098-843b-90209146c4dd,
abstract = {{<p>Background: Left ventricular longitudinal strain (LVLS) may be a sensitive indicator of left ventricular (LV) systolic function in patients with sepsis, but is dependent on high image quality and analysis software. Mitral annular plane systolic excursion (MAPSE) and the novel left ventricular longitudinal wall fractional shortening (LV-LWFS) are bedside echocardiographic indicators of LV systolic function that are less dependent on image quality. Both are sparsely investigated in the critically ill population, and may potentially be used as surrogates for LVLS. We assessed if LVLS may be predicted by LV-LWFS and MAPSE in patients with septic shock. We also assessed the repeatability and inter-rater agreement of LVLS, LV-LWFS and MAPSE measurements. Results: 122 TTE studies from 3 echocardiographic data repositories of patients admitted to ICU with septic shock were retrospectively assessed, of which 73 were suitable for LVLS analysis using speckle tracking. The correlations between LVLS vs. LV-LWFS and LVLS vs. MAPSE were 0.89 (p < 0.001) and 0.81 (p < 0.001) with mean squared errors of 5.8% and 9.1%, respectively. Using the generated regression equation, LV-LWFS predicted LVLS with a high degree of accuracy and precision, with bias and limits of agreement of -0.044 ± 4.7% and mean squared prediction error of 5.8%. Interobserver repeatability was good, with high intraclass correlation coefficients (0.96–0.97), small bias and tight limits of agreement (≤ 4.1% for all analyses) between observers for all measurements. Conclusions: LV-LWFS may be used to estimate LVLS in patients with septic shock. MAPSE also performed well, but was slightly inferior compared to LV-LWFS in estimating LVLS. Feasibility of MAPSE and LV-LWFS was excellent, as was interobserver repeatability.</p>}},
author = {{Johansson Blixt, Patrik and Chew, Michelle S. and Åhman, Rasmus and de Geer, Lina and Blomqwist, Lill and Åström Aneq, Meriam and Engvall, Jan and Andersson, Henrik}},
issn = {{2110-5820}},
keywords = {{Fractional shortening; Left ventricle; MAPSE; Sepsis; Strain; Systolic function}},
language = {{eng}},
number = {{1}},
publisher = {{Springer}},
series = {{Annals of Intensive Care}},
title = {{Left ventricular longitudinal wall fractional shortening accurately predicts longitudinal strain in critically ill patients with septic shock}},
url = {{http://dx.doi.org/10.1186/s13613-021-00840-6}},
doi = {{10.1186/s13613-021-00840-6}},
volume = {{11}},
year = {{2021}},
}