Global longitudinal strain to early detect myocardial dysfunction in septic shock: a systematic review
Bibliographic record
Abstract
INTRODUCTION: Sepsis-induced myocardial dysfunction (SIMD) is a common and reversible complication of septic shock that is often underdiagnosed due to the limitations of conventional echocardiography. Global longitudinal strain (GLS) derived from speckle tracking echocardiography (STE) may provide a more sensitive and load-independent marker of early myocardial dysfunction. The aim of this study was to assess the diagnostic and prognostic value of GLS in patients with septic shock in the ICU. EVIDENCE ACQUISITION: This systematic review followed the PRISMA guideline and published on PROSPERO (CRD420251034407). Four databases (PubMed, Scopus, Web of Science and Cochrane) were searched without time or language restrictions (Sept-Oct 2024). Eligible studies included adults with sepsis or septic shock studied with GLS. Risk of bias was assessed using the Newcastle-Ottawa Scale. EVIDENCE SYNTHESIS: Of 24 studies, five studies were included (416 patients). GLS was significantly reduced in patients with septic shock, even with preserved LVEF. A GLS threshold between -13% and -15% predicted mortality and correlated with biomarkers (troponin I, NT-proBNP, lactate). Compared to LVEF, GLS showed higher sensitivity in detecting subclinical dysfunction and in monitoring myocardial recovery. GLS in a single view (apical four-chamber) was comparable to full-view assessment, suggesting feasibility at the bedside. CONCLUSIONS: Despite the limited number and observational nature of the available studies, GLS appears to be a promising tool for the early detection and monitoring of myocardial dysfunction in septic shock. Its integration into ICU practice could improve risk stratification and individualized treatment. Further multicenter studies are needed to standardize the cut-offs and confirm the clinical benefit.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".