Full and simplified assessment of left ventricular diastolic function in covid‐19 patients admitted to ICU: Feasibility, incidence, and association with mortality

Via, Luigi La; Dezio, Veronica; Santonocito, Cristina; Astuto, Marinella; Morelli, Andrea; Huang, Stephen; Vieillard‐Baron, Antoine; Sanfilippo, Filippo

doi:10.1111/echo.15462

Cited by 25 publications

(22 citation statements)

References 42 publications

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“…Furthermore, the CMR examination allows for more comprehensive ventricular assessment, and the ability to interrogate flow in 3D allows for more accurate diastolic flow evaluation [ 13 , 14 ]. While more enhanced newer and perhaps more specific criteria for diastolic dysfunction have been developed on echocardiography [ 19 , 20 ], they tend to be cumbersome and involved in comparison to more easily-derived CMR variables as used in our study. CMR is often more effective at visualizing cardiac masses and pericardial disease than TTE, offering a broader range of applications beyond heart failure [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The Clinical Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Cardiac Diastolic Dysfunction

Bhuiya

Makaryus

2023

Medical Sciences

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Echocardiography is the gold standard clinical tool for the evaluation of left ventricular diastolic dysfunction (LVDD) and is used to validate other cardiac imaging modalities in measuring diastolic dysfunction. We examined Cardiac Magnetic Resonance Imaging (CMR) in detecting diastolic dysfunction using the time-volume curve-derived parameters compared to echocardiographic diastolic parameters. We evaluated patients who underwent both CMR and transthoracic echocardiography (TTE) within 2 ± 1 weeks of each other. On echo, Doppler/Tissue Doppler Imaging (TDI) measurements were obtained. On CMR, peak filling rate (PFR), time to PFR (TPFR), 1/3 filling fraction (1/3FF), and 1/3 filling rate (1/3FR) were calculated from the time-volume curve. Using the commonly employed E/A ratio, 44.4% of patients were found to have LVDD. Using septal E/E′ and lateral E/E′, 29.6% and 48.1% of patients had LVDD, respectively. Correlation was found between left atrial (LA) size and E/A ratio (R = −0.36). Using LVDD criteria for CMR, 63% of patients had diastolic dysfunction. CMR predicted LVDD in 66.7% of the cases. CMR-derived diastolic filling parameters provided a relatively easy and promising method for the assessment of LVDD and can predict the presence of LVDD as assessed by traditional Doppler and TDI methods.

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Section: Discussionmentioning

confidence: 99%

The Clinical Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Cardiac Diastolic Dysfunction

Bhuiya

Makaryus

2023

Medical Sciences

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“…28 Such discrepancy has been confirmed in patients with COVID-19, where a fair proportion of patients with normal LV diastolic function (2016) had grade II or grade III DD according to the simplified definition. 29 In another COVID-19 cohort, cardiac dysfunction was detected by speckle tracking echocardiography in 73% of patients, 60% of which with DD that correlated with immuno-inflammatory biomarkers. 30 From the above literature summary, it seems apparent that there are several concerns in applying the guidelines for the assessment of DD in the ICU setting, which could be summarized as follows.…”

Section: Are the La And Lvfp Of My Patients Elevated?mentioning

confidence: 98%

“…Moreover, they highlighted that ASE/EACVI 2016 guidelines designate many patients with normal LV diastolic function despite having an elevated E/e' ratio, hence with a high likelihood of increased LA pressure 28 . Such discrepancy has been confirmed in patients with COVID‐19, where a fair proportion of patients with normal LV diastolic function (2016) had grade II or grade III DD according to the simplified definition 29 . In another COVID‐19 cohort, cardiac dysfunction was detected by speckle tracking echocardiography in 73% of patients, 60% of which with DD that correlated with immuno‐inflammatory biomarkers 30 …”

Section: What Should You Question About the Bedside Management Of Lef...mentioning

confidence: 99%

Diastology in the intensive care unit: Challenges for the assessment and future directions

Gonzalez,

Santonocito,

Maybauer

et al. 2024

Echocardiography

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Myocardial dysfunction is common in patients admitted to the intensive care unit (ICU). Septic disease frequently results in cardiac dysfunction, and sepsis represents the most common cause of admission and death in the ICU. The association between left ventricular (LV) systolic dysfunction and mortality is not clear for critically ill patients. Conversely, LV diastolic dysfunction (DD) seems increasingly recognized as a factor associated with poor outcomes, not only in sepsis but also more generally in critically ill patients. Despite recent attempts to simplify the diagnosis and grading of DD, this remains relatively complex, with the need to use several echocardiographic parameters. Furthermore, the current guidelines have several intrinsic limitations when applied to the ICU setting. In this manuscript, we discuss the challenges in DD classification when applied to critically ill patients, the importance of left atrial pressure estimates for the management of patients in ICU, and whether the study of cardiac dysfunction spectrum during critical illness may benefit from the integration of left ventricular and left atrial strain data to improve diagnostic accuracy and implications for the treatment and prognosis.

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“…The use of E/e’ ratio together with e’ septal values has been suggested by Lanspa et al [ 16 , 17 ] to simplify the assessment of LV diastolic dysfunction in critically ill patients [ 18 ]. However, this assessment may not always provide interchangeable findings as compared to the guidelines used in the cardiology setting [ 19 ], as recently highlighted in patients with coronavirus disease-19 [ 20 – 22 ].…”

Section: Main Textmentioning

confidence: 99%

The interplay between left ventricular diastolic and right ventricular dysfunction: challenges in the interpretation of critical care echocardiography studies

et al. 2023

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Background Sepsis is a leading cause of death and it is characterized not only by profound vasoplegia but also by myocardial dysfunction. Critical care echocardiography is the preferred modality for the initial assessment of the cause of shock. Moreover, it can be extremely helpful in the identification of progressing myocardial dysfunction during the course of sepsis, also known as septic cardiomyopathy. Main body One of the issues in the identification of septic cardiomyopathy is that it can be manifest with different clinical phenotypes, from overt biventricular dysfunction to isolated left ventricular (LV) systolic and/or diastolic dysfunction, from right ventricular (RV) systolic dysfunction to RV failure and dilatation. However, the commonly used echocardiography parameters for the assessment of LV and/or RV function are not always entirely reliable. Indeed, these are influenced by variable preload and afterload conditions imposed by critical illness such as fluid shifts, sedation level and mechanical ventilation with positive pressure. Conclusions Strain echocardiography is a promising tool for the early identification of myocardial dysfunction in the context of sepsis. Studies reporting data on strain echocardiography should be particularly detailed in order to increase the reproducibility of results and to favor comparison with future studies.

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Full and simplified assessment of left ventricular diastolic function in covid‐19 patients admitted to ICU: Feasibility, incidence, and association with mortality

Cited by 25 publications

References 42 publications

The Clinical Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Cardiac Diastolic Dysfunction

The Clinical Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Cardiac Diastolic Dysfunction

Diastology in the intensive care unit: Challenges for the assessment and future directions

The interplay between left ventricular diastolic and right ventricular dysfunction: challenges in the interpretation of critical care echocardiography studies

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