Left ventricular longitudinal strain variations assessed by speckle-tracking echocardiography after a passive leg raising maneuver in patients with acute circulatory failure to predict fluid responsiveness: A prospective, observational study

Autor: Laurent Zieleskiewicz, Clemence Roy, Mickael Gardette, Alexandre Lopez, Eliott Gaudray, Marc Leone, Alain Boussuges, Cyril Nafati, François Antonini, Bruno Pastene, Gary Duclos
Přispěvatelé: Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Cardiac output
Etiology
[SDV]Life Sciences [q-bio]
Speckle tracking echocardiography
Blood Pressure
Pathology and Laboratory Medicine
Vascular Medicine
Diagnostic Radiology
Heart Rate
Ultrasound Imaging
Medicine and Health Sciences
Vasoconstrictor Agents
Prospective Studies
Cardiac Output
education.field_of_study
Multidisciplinary
Radiology and Imaging
Area under the curve
Heart
Shock
Middle Aged
Hospitals
Echocardiography
Doppler
Intensive Care Units
Treatment Outcome
Echocardiography
Cardiology
Medicine
lipids (amino acids
peptides
and proteins)
Female
Anatomy
Research Article
Cardiac function curve
Adult
medicine.medical_specialty
Imaging Techniques
Cardiac Ventricles
Science
Population
Diastole
Research and Analysis Methods
Sensitivity and Specificity
Signs and Symptoms
Diagnostic Medicine
Internal medicine
Sepsis
medicine
Humans
education
Aged
Leg
business.industry
Repeated measures design
Biology and Life Sciences
Stroke Volume
Health Care
Preload
Health Care Facilities
Cardiovascular Anatomy
Fluid Therapy
Clinical Medicine
business
Zdroj: PLoS ONE
PLoS ONE, 2021, 16 (9), pp.e0257737. ⟨10.1371/journal.pone.0257737⟩
PLoS ONE, Vol 16, Iss 9, p e0257737 (2021)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0257737⟩
Popis: Background An association was reported between the left ventricular longitudinal strain (LV-LS) and preload. LV-LS reflects the left cardiac function curve as it is the ratio of shortening over diastolic dimension. The aim of this study was to determine the sensitivity and specificity of LV-LS variations after a passive leg raising (PLR) maneuver to predict fluid responsiveness in intensive care unit (ICU) patients with acute circulatory failure (ACF). Methods Patients with ACF were prospectively included. Preload-dependency was defined as a velocity time integral (VTI) variation greater than 10% between baseline (T0) and PLR (T1), distinguishing the preload-dependent (PLD+) group and the preload-independent (PLD-) group. A 7-cycles, 4-chamber echocardiography loop was registered at T0 and T1, and strain analysis was performed off-line by a blind clinician. A general linear model for repeated measures was used to compare the LV-LS variation (T0 to T1) between the two groups. Results From June 2018 to August 2019, 60 patients (PLD+ = 33, PLD- = 27) were consecutively enrolled. The VTI variations after PLR were +21% (±8) in the PLD+ group and -1% (±7) in the PLD- group (pp = 0.12). LV-LS increased in the whole population after PLR +16.0% (±4.0) (p = 0.04). The LV-LS variations after PLR were +19.0% (±31) (p = 0.05) in the PLD+ group and +11.0% (±38) (p = 0.25) in the PLD- group, with no significant difference between the two groups (p = 0.08). The area under the curve for the LV-LS variations between T0 and T1 was 0.63 [0.48–0.77]. Conclusion Our study confirms that LV-LS is load-dependent; however, the variations in LV-LS after PLR is not a discriminating criterion to predict fluid responsiveness of ICU patients with ACF in this cohort.
Databáze: OpenAIRE
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