1.The prediction model of septic shock was constructed with multiple parameters
Liling LAI ; Baoquan CHEN ; Zhu'e WU ; Jiguang ZHOU ; Huobiao SHE ; Ming CHEN
Chinese Journal of Emergency Medicine 2025;34(6):852-857
Objective:To develop and validate a predictive model for septic shock using noninvasive left ventricular pressure-strain loop myocardial work parameters combined with clinical indicators.Methods:In this retrospective study, 105 septic patients admitted to the intensive care unit of Zhangzhou Hospital between January and December 2023 were analyzed after screening (initial cohort: 124 patients). Participants were stratified into non-shock ( n=38) and shock ( n=67) groups based on septic shock occurrence within 48 hours of admission. Demographic characteristics, laboratory parameters, clinical variables, and myocardial work indices were compared between groups. Independent risk factors were identified through multivariate logistic regression, and a predictive model was constructed. Results:Five independent predictors of septic shock were identified: Left ventricular global longitudinal strain (GLS) ≥ -16% (X 1).Global work index (GWI) <1 196.5 mmHg% (X 2).Brain natriuretic peptide (BNP) ≥299.81 pg/mL (X 3).Lactate (Lac) ≥4.75 mmol/L (X 4).Mean arterial pressure (MAP) <68.5 mmHg (X 5).The derived model equation was:Y = -21.104 + 3.517×X 1 + 2.066×X 2 + 1.941×X 3 + 3.440×X 4 + 3.526×X 5.ROC analysis determined an optimal diagnostic cutoff of -13.6185 points (rounded to -14 for clinical practicality). Scores≥-14 indicated high septic shock risk. The model demonstrated excellent discrimination (AUC=0.960, 95% CI=0.919-0.998) and goodness-of-fit (Hosmer-Lemeshow test, P=0.804). Conclusions:This novel predictive model integrating myocardial work parameters and clinical indicators exhibits outstanding diagnostic performance for early septic shock detection, potentially enabling timely therapeutic intervention.
2.Vector flow mapping evaluation of regional left ventricular flow structure in patients with myocardial infarction
Shuping YANG ; Haolin SHEN ; Wenting JANG ; Huobiao SHE ; Jiahua YE
Chinese Journal of Ultrasonography 2012;(7):575-580
Objective To evaluate blood flow structure within left ventricle,quantify the variation of the flow at infarct segments,and assess the impact of myocardial infarction.Methods Twenty-eight patients with chronic myocardial infarction(CMI)and 30 healthy controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by vector flow mapping(VFM).Timeflow(T-F)curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile were analyzed by DSA-RSI program.Results Ventricular ejction peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower in CMI group at infarct segment than normal control group,the time duration from bottom to peak was relatively longer in CMI group.Normal velocity profile,parallel velocity profile,vector profile,flow profile at peak S and E were lower in CMI group than normal group.Conclusions The velocity of CMI group was lower and the time to peak was longer than that of control group.VFM is a new noninvasive and clinically useful parameter for the evaluation of regional left ventricular segment flow dynamics.

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