Key result
Tissue motion annular displacement (TMADMid) demonstrated excellent discriminatory value for predicting sepsis-induced cardiomyopathy with an AUROC of 0.902.
Why the study?
There are no formal diagnostic criteria for SICM, and the feasibility, discriminatory value for predicting SICM, and prognostic value of TMAD were unknown.
Does tissue motion annular displacement (TMAD) improve the prediction of sepsis-induced cardiomyopathy in patients with sepsis or septic shock?
Observational (n=143)
No
Does tissue motion annular displacement (TMAD) improve the prediction of sepsis-induced cardiomyopathy in patients with sepsis or septic shock?
Effect estimate: AUROC 0.902 (95% CI 0.844-0.961)
p-value: p=<0.001
STE-based TMAD is a feasible, rapid, and highly discriminatory echocardiographic parameter for predicting sepsis-induced cardiomyopathy.
BACKGROUND: There is no formal diagnostic criterion for sepsis-induced cardiomyopathy (SICM), but left ventricular ejection fraction (LVEF) < 50% was the most commonly used standard. Tissue motion annular displacement (TMAD) is a novel speckle tracking indicator to quickly assess LV longitudinal systolic function. This study aimed to evaluate the feasibility and discriminatory value of TMAD for predicting SICM, as well as prognostic value of TMAD for mortality. METHODS: We conducted a single-center retrospective observational study in patients with sepsis or septic shock who underwent echocardiography examination within the first 24 h after admission. Basic clinical information and conventional echocardiographic data, including mitral annular plane systolic excursion (MAPSE), were collected. Based on speckle tracking echocardiography (STE), global longitudinal strain (GLS) and TMAD were, respectively, performed offline. The parameters acquisition rate, inter- and intra-observer reliability, time consumed for measurement were assessed for the feasibility analysis. Areas under the receiver operating characteristic curves (AUROC) values were calculated to assess the discriminatory value of TMAD/GLS/MAPSE for predicting SICM, defined as LVEF < 50%. Kaplan-Meier survival curve analysis was performed according to the cutoff values in predicting SICM. Cox proportional hazards model was performed to determine the risk factors for 28d and in-hospital mortality. RESULTS: A total of 143 patients were enrolled in this study. Compared with LVEF, GLS or MAPSE, TMAD exhibited the highest parameter acquisition rate, intra- and inter-observer reliability. The mean time for offline analyses with TMAD was significantly shorter than that with LVEF or GLS (p < 0.05). According to the AUROC analysis, TMADMid presented an excellent discriminatory value for predicting SICM (AUROC > 0.9). Patients with lower TMADMid (< 9.75 mm) had significantly higher 28d and in-hospital mortality (both p < 0.05). The multivariate Cox proportional hazards model revealed that BMI and SOFA were the independent risk factors for 28d and in-hospital mortality in sepsis cases, but TMAD was not. CONCLUSION: STE-based TMAD is a novel and feasible technology with promising discriminatory value for predicting SICM with LVEF < 50%.
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Song et al. (2022) conducted an observational in Sepsis or septic shock (n=143). Tissue motion annular displacement (TMAD) vs. LVEF, GLS, and MAPSE was evaluated on Discriminatory value of TMADMid for predicting sepsis-induced cardiomyopathy (LVEF < 50%) (AUROC 0.902, 95% CI 0.844-0.961, p=<0.001). Tissue motion annular displacement (TMADMid) demonstrated excellent discriminatory value for predicting sepsis-induced cardiomyopathy with an AUROC of 0.902.
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