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Master Thesis

Prognostic value and time course evolution of left ventricular Global Longitudinal Strain in septic shock: an exploratory prospective study

Abstract : Introduction: GLS is a new tool for systolic function assessment. The present study aims to describe the course of GLS comparing to LVEF during the first days of the septic shock. We also assessed the correlation between GLS values and longitudinal strain measured in apical two three or four chambers. Finally, we assessed the correlation between GLS changes and patient outcome. Methods: a prospective observational single center study was performed in the ICU of the Nimes university hospital, France. After approval of the local ethics committee, all patients admitted to the ICU for septic shock without pre-existing heart disease were eligible Echocardiography was performed on the first day, and repeated once between day 3 and day 5 then once between day 6 and day 8. LVEF and GLS were acquired in apical two-chamber, fourchamber and long-axis views. Results: we enrolled 40 consecutive patients. Two patients were excluded for coronary heart disease and one for atrial fibrillation. In all population GLS in T1 is impaired. On T2 exams, a significant improvement of the GLS (-11,1 vs -14,2 p= 0,012; [ 0.7 ; 5.5 ]) is observed. These variations aren’t observed for LVEF which remains stable over time. We have a good correlation between GLS and longitudinal strain measured on a four chambers view. Evaluated by Bland and Altman method the mean of differences for T1 exams was -0.04 (-0.7: 0.62). Conclusion: myocardial strain is depressed at the early phase of septic shock and improves over time. A single measurement of GLS in a 4 chambers view appears sufficient at bedside as compared to complete myocardial evaluation (2, 4 chambers and APLX views). Finally, our results support the idea that GLS at day 1 (and not subsequent days) is associated with patient outcome.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02952342
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Submitted on : Tuesday, September 29, 2020 - 12:27:00 PM
Last modification on : Monday, October 11, 2021 - 1:25:03 PM

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Florian Bazalgette. Prognostic value and time course evolution of left ventricular Global Longitudinal Strain in septic shock: an exploratory prospective study. Human health and pathology. 2018. ⟨dumas-02952342⟩

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