To evaluate the clinical utility of GLS, MAPSE, and S’ in critically ill patients, assessing their feasibility, relationship with LVEF, and prognostic value for 90-day mortality.
Approach:
Patient Population: Included critically ill patients from the general and neuro ICU at Sahlgrenska University hospital, with specific inclusion criteria: age > 18 years, TTE within 24 hours of ICU admission, and a SOFA score greater than one.
Echocardiographic Examination: Performed TTE within 24 hours of ICU admission, assessing LVEF, GLS, MAPSE, and S’. The examination was conducted after initial cardiovascular stabilization and volume resuscitation.
Key Findings:
GLS, MAPSE, and S’ are potentially more reliable measures of systolic function than LVEF in critically ill patients, as supported by several studies.
Impaired GLS is associated with increased mortality in sepsis and COVID-19 patients, as demonstrated in recent meta-analyses.
MAPSE and S’ have shown links to adverse outcomes but require further evidence in heterogeneous ICU populations.
Interpretation:
The study highlights the need for alternative echocardiographic measures in critically ill patients, given the limitations of LVEF.
Limitations:
The study is based on a secondary analysis of existing data.
Evidence for MAPSE and S’ in diverse ICU populations is limited.
Conclusion:
GLS, MAPSE, and S’ may provide valuable insights into left ventricular function and prognosis in critically ill patients.
