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Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock

BACKGROUND: Using easy-to-determine bedside measurements, we developed an echocardiographic algorithm for predicting left ventricular ejection fraction (LVEF) and longitudinal strain (LVLS) in patients with septic shock. METHODS: We measured septal and lateral mitral annular plane systolic excursion...

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Detalles Bibliográficos
Autores principales: Brault, Clément, Zerbib, Yoann, Mercado, Pablo, Diouf, Momar, Michaud, Audrey, Tribouilloy, Christophe, Maizel, Julien, Slama, Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457489/
https://www.ncbi.nlm.nih.gov/pubmed/37638090
http://dx.doi.org/10.1016/j.bjao.2023.100220
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author Brault, Clément
Zerbib, Yoann
Mercado, Pablo
Diouf, Momar
Michaud, Audrey
Tribouilloy, Christophe
Maizel, Julien
Slama, Michel
author_facet Brault, Clément
Zerbib, Yoann
Mercado, Pablo
Diouf, Momar
Michaud, Audrey
Tribouilloy, Christophe
Maizel, Julien
Slama, Michel
author_sort Brault, Clément
collection PubMed
description BACKGROUND: Using easy-to-determine bedside measurements, we developed an echocardiographic algorithm for predicting left ventricular ejection fraction (LVEF) and longitudinal strain (LVLS) in patients with septic shock. METHODS: We measured septal and lateral mitral annular plane systolic excursion (MAPSE), septal and lateral mitral S-wave velocity, and the left ventricular longitudinal wall fractional shortening in patients with septic shock. We used a conditional inference tree method to build a stratification algorithm. The left ventricular systolic dysfunction was defined as an LVEF <50%, an LVLS greater than −17%, or both. RESULTS: We included 71 patients (males: 61%; mean [standard deviation] age: 61 [15] yr). Septal MAPSE (cut-off: 1.2 cm) was the best predictor of left ventricular systolic dysfunction. The level of agreement between the septal MAPSE and the left ventricular systolic dysfunction was 0.525 [0.299–0.751]. A septal MAPSE ≥1.2 cm predicted normal LVEF in 17/18 patients, or 94%. In contrast, a septal MAPSE <1.2 cm predicted left ventricular systolic dysfunction with impaired LVLS in 46/53 patients (87%), although 32/53 (60%) patients had a preserved LVEF. CONCLUSIONS: Septal MAPSE is easily measured at the bedside and might help clinicians to detect left ventricular systolic dysfunction early—especially when myocardial strain measurements are not feasible.
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spelling pubmed-104574892023-08-27 Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock Brault, Clément Zerbib, Yoann Mercado, Pablo Diouf, Momar Michaud, Audrey Tribouilloy, Christophe Maizel, Julien Slama, Michel BJA Open Original Research Article BACKGROUND: Using easy-to-determine bedside measurements, we developed an echocardiographic algorithm for predicting left ventricular ejection fraction (LVEF) and longitudinal strain (LVLS) in patients with septic shock. METHODS: We measured septal and lateral mitral annular plane systolic excursion (MAPSE), septal and lateral mitral S-wave velocity, and the left ventricular longitudinal wall fractional shortening in patients with septic shock. We used a conditional inference tree method to build a stratification algorithm. The left ventricular systolic dysfunction was defined as an LVEF <50%, an LVLS greater than −17%, or both. RESULTS: We included 71 patients (males: 61%; mean [standard deviation] age: 61 [15] yr). Septal MAPSE (cut-off: 1.2 cm) was the best predictor of left ventricular systolic dysfunction. The level of agreement between the septal MAPSE and the left ventricular systolic dysfunction was 0.525 [0.299–0.751]. A septal MAPSE ≥1.2 cm predicted normal LVEF in 17/18 patients, or 94%. In contrast, a septal MAPSE <1.2 cm predicted left ventricular systolic dysfunction with impaired LVLS in 46/53 patients (87%), although 32/53 (60%) patients had a preserved LVEF. CONCLUSIONS: Septal MAPSE is easily measured at the bedside and might help clinicians to detect left ventricular systolic dysfunction early—especially when myocardial strain measurements are not feasible. Elsevier 2023-08-12 /pmc/articles/PMC10457489/ /pubmed/37638090 http://dx.doi.org/10.1016/j.bjao.2023.100220 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Research Article
Brault, Clément
Zerbib, Yoann
Mercado, Pablo
Diouf, Momar
Michaud, Audrey
Tribouilloy, Christophe
Maizel, Julien
Slama, Michel
Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title_full Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title_fullStr Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title_full_unstemmed Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title_short Mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
title_sort mitral annular plane systolic excursion for assessing left ventricular systolic dysfunction in patients with septic shock
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10457489/
https://www.ncbi.nlm.nih.gov/pubmed/37638090
http://dx.doi.org/10.1016/j.bjao.2023.100220
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