Left ventricular systolic function evaluated by strain echocardiography and relationship with mortality in patients with severe sepsis or septic shock: a systematic review and meta-analysis

Sanfilippo, Filippo; Corredor, Carlos; Fletcher, Nick; Tritapepe, Luigi; Lorini, Ferdinando Luca; Arcadipane, Antonio; Vieillard‐Baron, Antoine; Cecconi, Maurizio

doi:10.1186/s13054-018-2113-y

Cited by 142 publications

(115 citation statements)

References 85 publications

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“…[72] In a meta-analysis of adult patients with sepsis, increased (i.e., less negative) global longitudinal strain values were associated with mortality; this nding was not seen with ejection fraction -the most commonly used parameter to evaluate adult cardiac function in sepsis. [73] Additionally, changes in myocardial strain have been shown to correlate with the upregulation of in ammatory cytokines and mitochondrial dysfunction in the form of an increased in mitochondrial ROS. [72] In our study, eCIRP worsened both longitudinal and radial cardiac strain, providing direct evidence that eCIRP causes cardiac dysfunction in neonatal sepsis.…”

Section: Discussionmentioning

confidence: 99%

Targeting the eCIRP/TREM-1 Interaction with a Small Molecule Inhibitor Improves Cardiac Dysfunction in Neonatal Sepsis

Denning

Aziz

et al. 2020

Preprint

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Background: Neonatal sepsis and the associated myocardial dysfunction remain a leading cause of infant mortality. Extracellular cold-inducible RNA-binding protein (eCIRP) acts as a ligand of triggering receptor expressed on myeloid cells-1 (TREM-1). M3 is a small CIRP-derived peptide that inhibits the eCIRP/TREM-1 interaction. We hypothesize that the eCIRP/TREM-1 interaction in cardiomyocytes contributes to sepsis-induced cardiac dysfunction in neonatal sepsis, while M3 is cardioprotective. Methods: Serum was collected from neonates in the Neonatal Intensive Care Unit (NICU). 5-7-day old C57BL/6 mouse pups were used in this study. Primary murine neonatal cardiomyocytes were stimulated with recombinant murine (rm) CIRP with M3. TREM-1 mRNA and supernatant cytokine levels were assayed. Mitochondrial oxidative stress, ROS, and membrane potential were assayed. Neonatal mice were injected with rmCIRP and speckle-tracking echocardiography was conducted to measure cardiac strain. Sepsis was induced by i.p. cecal slurry. Mouse pups were treated with M3 or vehicle. After 16 h, echocardiography was performed followed by euthanasia for tissue analysis. A 7-day survival study was conducted. Results: Serum CIRP levels were elevated in septic human neonates. rmCIRP stimulation of cardiomyocytes increased TREM-1 gene expression. Stimulation of cardiomyocytes with rmCIRP upregulated TNF-α and IL-6 in the supernatants, while this upregulation was inhibited by M3. Stimulation of cardiomyocytes with rmCIRP resulted in a reduction in mitochondrial membrane potential (MMP) while M3 treatment returned MMP to near baseline. rmCIRP caused mitochondrial calcium overload; this was inhibited by M3. rmCIRP injection impaired longitudinal and radial cardiac strain. Sepsis resulted in cardiac dysfunction with a reduction in cardiac output and left ventricular end diastolic diameter. Both were improved by M3 treatment. Treatment with M3 attenuated serum, cardiac, and pulmonary levels of pro-inflammatory cytokines compared to vehicle-treated septic neonates. M3 dramatically increased sepsis survival. Conclusions: Inhibition of eCIRP/TREM-1 interaction with M3 is cardioprotective, decreases inflammation, and improves survival in neonatal sepsis. Trial registration: Retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Targeting the eCIRP/TREM-1 Interaction with a Small Molecule Inhibitor Improves Cardiac Dysfunction in Neonatal Sepsis

Denning

Aziz

et al. 2020

Preprint

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“…Several recent studies and a review/meta-analysis 11 shed light on the important question; is GLS is a better predictor of mortality in sepsis cardiomyopathy than the traditional parameter; LV ejection fraction. In their meta-analysis [ 11 ], the authors pooled available and eligible observational studies that included 794 patients with severe sepsis and/or septic shock.…”

Section: Reviewmentioning

confidence: 99%

Is Left Ventricular Global Longitudinal Strain by Two-Dimensional Speckle Tracking Echocardiography in Sepsis Cardiomyopathy ready for prime time use in the ICU?

Velagapudi¹,

Pidikiti²,

Tighe³

2018

Preprint

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Myocardial deformation imaging (strain imaging) is a technique to directly quantify the extent of myocardial contractility and overcomes several of the limitations of ejection fraction. The application of the most commonly used strain imaging method; speckle-tracking echocardiography to patients with sepsis cardiomyopathy heralds an exciting development to the field. However; the body of evidence and knowledge on the utility, feasibility and prognostic value of left ventricular global longitudinal strain in sepsis cardiomyopathy is still evolving. We conducted a review of literature on utility of left ventricular global longitudinal strain in sepsis cardiomyopathy. We discuss the role of left ventricular global longitudinal strain in mortality prediction, utility and limitations of the technique in the context of sepsis cardiomyopathy.

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“…In a meta‐analysis of 8 studies involving 794 patients, there was a significant association between the worse LV function and GLS values and mortality (standard mean difference −0.26; 95% CI‐ 0.47, −0.04, P ‐ .02) in patients with severe sepsis/and or septic shock. There was no association between LVEF and mortality in the same population of patients . Therefore, the mechanism leading to prechemotherapy changes in the LV systolic function is still elusive.…”

mentioning

confidence: 94%

Prechemotherapy subclinical left ventricular dysfunction: Do we know the mechanism?

et al. 2020

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We would like to thank Dr Tadic and colleague for their interest in our research manuscript titled "Pediatric Malignancies: Is the Pre-chemotherapy Left Ventricular Function Normal?" 1 and their contribution in the research related to chemotherapy-induced cardiomyopathy. Tadic et al have recently published their research findings of abnormal left ventricular (LV) systolic function in 122chemotherapy naïve and radiotherapy naïve cancer patients (prechemotherapy) and 45 age-matched controls. They reported signifition exists, which can be detected by the speckle tracking echocardiography. As more and more research data are being published, we propose adding the speckle echocardiography for assessing the LV systolic function in patients even before they have received chemotherapy. This may help stratify high-risk patients who are at risk for chemotherapy and radiotherapy induced cardiotoxicity.Jyothsna Akam-Venkata MBBS

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Left ventricular systolic function evaluated by strain echocardiography and relationship with mortality in patients with severe sepsis or septic shock: a systematic review and meta-analysis

Cited by 142 publications

References 85 publications

Targeting the eCIRP/TREM-1 Interaction with a Small Molecule Inhibitor Improves Cardiac Dysfunction in Neonatal Sepsis

Targeting the eCIRP/TREM-1 Interaction with a Small Molecule Inhibitor Improves Cardiac Dysfunction in Neonatal Sepsis

Is Left Ventricular Global Longitudinal Strain by Two-Dimensional Speckle Tracking Echocardiography in Sepsis Cardiomyopathy ready for prime time use in the ICU?

Prechemotherapy subclinical left ventricular dysfunction: Do we know the mechanism?

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