The role of speckle tracking echocardiography for prognostication in patients with severe sepsis or septic shock

Ng et al. [1] reported the results of a very interesting study on sepsis-induced myocardial dysfunction. The authors elegantly matched patients with septic shock (90-day mortality of 41.9 %) with a control group of patients with sepsis (90-day mortality of 0 %) using a relatively novel and more sophisticated echocardiographic approach for the diagnosis of myocardial dysfunction in septic patients—speckle tracking echocardiography. With this approach, systolic dysfunction was assessed by means of global longitudinal strain (GLS) and showed a greater degree of myocardial dysfunction in patients with septic shock compared with controls (GLS −14.5 versus −18.3 %, respectively). On the other hand, left ventricular ejection fraction (LVEF) was similar among groups, again confirming that LVEF does not seem appropriate for evaluating myocardial dysfunction in such a population. This finding is in agreement with recent evidence suggesting no correlation between LVEF and mortality in patients with severe sepsis or septic shock, while an association between diastolic dysfunction and mortality has been suggested [2].