Key result
Global longitudinal strain assessed by 2D-strain echocardiography was significantly different in cirrhotic ICU patients who died at 28 days compared to survivors (-17 vs -14; p<0.039).
Why the study?
Conventional echocardiography has poor diagnostic performance for cirrhotic cardiomyopathy, and the prognostic value of two-dimensional strain echocardiography in cirrhotic ICU patients is unclear.
Does two-dimensional strain-echocardiography predict 28-day mortality better than conventional echocardiography in patients with liver cirrhosis in the ICU?
Observational (n=44)
Does two-dimensional strain-echocardiography predict 28-day mortality better than conventional echocardiography in patients with liver cirrhosis in the ICU?
Answers are grounded in this paper and cite their sources.
Two-dimensional strain echocardiography (GLS) provides significant prognostic value for 28-day mortality in ICU patients with liver cirrhosis, whereas conventional echocardiography does not.
Cirrhotic cardiomyopathy (CCM) is a major comorbidity of cirrhosis. The diagnostic performance of conventional echocardiography is poor. Two-dimensional-strain echo-cardiography (2D-strain) detects myocardial dysfunction earlier than conventional echocardiography, with a significant prognostic value. The aim of our study is to assess whether the 2D-strain will allow a more relevant assessment of CCM in cirrhotic patients than conventional echocardiography. The secondary objective is to determine if altered strain or strain rate are associated with cirrhotic patient's outcome in intensive care unit (ICU). Conventional echocardiography and 2D-strain were performed on 44 consecutive patients within 24 hours of admission to the ICU. Using 2D-strain, the global-longitudinal-strain (GLS) was assessed. GLS was impaired in 64% of patients. GLS was significantly higher in the patients who died compared with those who survived, using 28-day mortality rate (-17 vs -14 p < 0.039). Regarding conventional echocardiography, no factor was associated with increased mortality. GLS is correlated to cirrhotic patient's prognosis in intensive care, while conventional echocardiography shows no dysfunction.
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Boukili et al. (2023) conducted an observational in Liver cirrhosis (n=44). Two-dimensional strain-echocardiography (2D-strain) vs. Conventional echocardiography was evaluated on 28-day mortality (p=<0.039). Global longitudinal strain assessed by 2D-strain echocardiography was significantly different in cirrhotic ICU patients who died at 28 days compared to survivors (-17 vs -14; p<0.039).
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