Prognostic value and clinical net benefit of global longitudinal strain in sepsis: a prospective study with internal bootstrap validation.
Cardiac strain measurement predicted 28-day sepsis mortality better than ejection fraction
Prognostic value and clinical net benefit of global longitudinal strain in sepsis: a prospective study with internal bootstrap validation.
Conventional left ventricular ejection fraction (left ventricular ejection fraction) often fails to detect early sepsis-induced myocardial dysfunction (sepsis-induced myocardial dysfunction).
This study aimed to evaluate the prognostic utility of speckle-tracking echocardiography (speckle-tracking echocardiography)-derived global longitudinal strain (global longitudinal strain) and to develop an internally validated clinical nomogram with demonstrated net benefit for predicting 28-day mortality in sepsis patients.
This prospective observational study enrolled 46 patients presenting with sepsis or septic shock at the Emergency Department of The First Affiliated Hospital of Sun Yat-sen University (February-June 2023).
higher scores predicted death more accurately than ejection fraction
The 28-day mortality rate was 23.9% (11/46).
GLS_AVG strongly correlated with SOFA ( r = 0.663) and NT-proBNP peak ( r = 0.424).
The optimal GLS_AVG cutoff was > -11.0% (sensitivity 72.7%, specificity 82.9%).
In restricted multivariable analysis, GLS_AVG showed a borderline independent association with 28-day mortality in the restricted multivariable model (OR: 1.266; 95% CI: 0.995-1.676; P = 0.067).
Speckle-tracking echocardiography-derived global longitudinal strain is a highly sensitive, relatively load-independent marker of early myocardial dysfunction in sepsis, significantly outperforming left ventricular ejection fraction in predicting 28-day mortality.
The validated global longitudinal strain-SOFA nomogram and decision curve models provide a practical, high-yield tool to enhance risk stratification and guide early personalized hemodynamic resuscitation in emergency settings.