(1592) Feasibility of Speckle-Tracking Echocardiography for Right Ventricular Dysfunction in Sepsis

Introduction: The accuracy of traditional echocardiographic parameters depends on imaging angles and quality, and there is no consensus on the definition of right ventricular dysfunction (RVD) in sepsis. Speckle tracking echocardiography (STE) is a relatively new technology that allows assessment of ventricular systolic function. The aim of this study is to assess the feasibility, diagnostic accuracy and prognostic value of STE for RVD in sepsis.

Methods: This retrospective observational study was conducted at a single center and included patients with sepsis who underwent echocardiography within the first 24 hours of admission. RV longitudinal strain (RVLS) and RV tissue motion annular displacement (RVTMAD) were measured offline using STE. The feasibility analysis and diagnostic accuracy of STE for RVD was evaluated. Kaplan-Meier survival curve analysis was performed to determine the prognostic value of STE. Cox proportional hazards model analysis was conducted to identify risk factors for 28-day and in-hospital mortality.

Results: A total of 159 septic patients were enrolled in the study. RVTMAD presented highest feasibility, as well as highest diagnostic accuracy for RVD in sepsis. Patients with RVTMADmid < 10.95 mm, RVTMAD% < 16.70% or RVFWLS ≥ -18.85% had higher in-hospital mortality and patients with RVFWLS ≥ -18.85% had higher 28-day mortality. Sequential Organ Failure Assessment score and tricuspid annular plane systolic excursion (TAPSE) were independent risk factors for 28-day and in-hospital mortality in sepsis.

Conclusions: STE is a novel, feasible technique for evaluating RV function in sepsis. RVTMAD exhibits relatively high diagnostic accuracy for RVD in septic patients.