A novel speckle-tracking echocardiography parameter assessing left ventricular afterload.

Autor: Sato K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Wildi K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.; Department of Intensive Care Medicine, University Hospital Basel, Basel, Switzerland.; Faculty of Medicine, University of Basel, Basel, Switzerland., Chan J; Cardiology Department, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Griffith University, School of Medicine, Brisbane, Queensland, Australia., Palmieri C; The University of Queensland, School of Veterinary Science, Gatton, Australia., Obonyo NG; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.; DeAL/KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.; Wellcome Trust Centre for Global Health Research, Imperial College London, London, UK., Heinsar S; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Liu K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Livingstone S; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Sato N; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia., Ainola C; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Abbate G; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia., Bouquet M; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Wilson E; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Passmore M; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Hyslop K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Platts DG; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Cardiology Department, The Prince Charles Hospital, Brisbane, Queensland, Australia., Suen J; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Bassi GL; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia., Fraser JF; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2024 Feb; Vol. 54 (2), pp. e14106. Date of Electronic Publication: 2023 Oct 11.
DOI: 10.1111/eci.14106
Abstrakt: Background: Left ventricular stroke work index (LVSWI) and afterload-related cardiac performance (ACP) consider left ventricular (LV) afterload and could be better prognosticators in septic cardiomyopathy. However, their invasive nature prevents their routine clinical applications. This study aimed to investigate (1) whether a proposed speckle-tracking echocardiography parameter, Pressure-Strain Product (PSP), can non-invasively predict catheter-based LVSWI, ACP and serum lactate in an ovine model of septic cardiomyopathy; and (2) whether PSP can distinguish the sub-phenotypes of acute respiratory distress syndrome (ARDS) with or without sepsis-like conditions.
Methods: Sixteen sheep with ARDS were randomly assigned to either (1) sepsis-like (n = 8) or (2) non-sepsis-like (n = 8) group. Each ARDS and sepsis-like condition was induced by intravenous infusion of oleic acid and lipopolysaccharide, respectively. Pulmonary artery catheter-based LVSWI (the product of stroke work index, mean arterial pressure and .0136), ACP (the percentage of cardiac output measured to cardiac output predicted as normal) and serum lactate were measured simultaneously with transthoracic echocardiography. Two PSP indices were calculated by multiplying the mean arterial blood pressure and either global circumferential strain (PSPcirc) or radial strain (PSPrad).
Results: PSPcirc showed a significant correlation with LVSWI (r 2  = .66, p < .001) and ACP (r 2  = .82, p < .001) in the sepsis-like group. Although PSP could not distinguish subphenotypes, PSPcirc predicted LVSWI (AUC .86) and ACP (AUC .88), and PSPrad predicted serum lactate (AUC .75) better than LV ejection fraction, global circumferential and radial strain.
Conclusions: A novel PSP has the potential to non-invasively predict catheter-based LVSWI and ACP, and was associated with serum lactate in septic cardiomyopathy.
(© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
Databáze: MEDLINE
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