Diagnostic value of tissue motion annular displacement in sepsis-induced cardiomyopathy: a single-center retrospective observational study

Abstract

Background Currently, there is no formal diagnostic criterion for sepsis-induced cardiomyopathy (SICM). The classic approach has been to use left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) to define SICM. In this regard, 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 application value of TMAD in the diagnosis of SICM in septic patients. Methods We conducted a single-center retrospective observational study in sepsis or septic shock patients who underwent echocardiography examination within the first 24h after admission. Basic clinical information and conventional echocardiographic data were collected. Based on speckle tracking echocardiography (STE), GLS and TMAD were respectively performed offline. The correlations between TMAD and other LV systolic function parameters, as well as the diagnostic value of TMAD for SICM, were assessed. Data of 28d and in-hospital mortality were compared between SICM and non-SICM patients. Results A total of 143 patients were enrolled in this study. The incidence of SICM according to GLS or TMAD criteria was significantly higher than that according to LVEF criteria (32.9% vs. 18.2%, p = 0.006; 38.5% vs. 18.2%, p < 0.001). The 28d and in-hospital mortality of SICM patients were significantly higher than the non-SICM patients according to any of the diagnostic criteria (all p < 0.05). Significant correlations between TMAD and other LV systolic function echocardiographic parameters, including LVEF, GLS, mitral annular plane systolic excursion (MAPSE), and maximal lateral systolic mitral annular tissue velocity (MA Smax), were detected (all p < 0.001). According to the AUROC value, TMADMid had an excellent diagnostic value for SICM (AUROC > 0.9). Compared with LVEF and GLS, TMAD had the highest intra-observer and inter-observer reliability. The mean time for off-line analyses with TMAD was significantly shorter than that with LVEF or GLS (p < 0.05). Conclusion STE-based TMAD is a feasible, reliable, and time-saving option to assess the LV systolic function. Overall, this approach shows an excellent diagnostic value for SICM in septic patients.