Systolic dysfunction as evaluated by tissue Doppler imaging echocardiography and mortality in septic patients: A systematic review and meta-analysis

Sanfilippo, Filippo; Huang, Stephen; Messina, Antonio; Franchi, Federico; Oliveri, Francesco; Vieillard‐Baron, Antoine; Cecconi, Maurizio; Astuto, Marinella

doi:10.1016/j.jcrc.2020.12.026

Cited by 36 publications

(33 citation statements)

References 52 publications

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“…For instance, 9 studies [ 17 , 22 , 24 , 30 , 32 , 34 , 41 , 42 , 44 ] reported a low mean troponin I level of 0.07 ± 0.09 ng/ml (Supplementary Materials raw data) which, once ruled out acute coronary ischemia, may be considered of multifactorial origin [ 50 ]. As part of routine bedside clinical assessment, echocardiography has gained popularity in ICU because of its wide availability, high diagnostic yield, and prognostic value [ [51] , [52] , [53] , [54] , [55] , [56] , [57] ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

Messina

Sanfilippo

Milani

et al. 2021

Journal of Critical Care

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Purpose Coronavirus disease 2019 (COVID-19) infection may trigger a multi-systemic disease involving different organs. There has been growing interest regarding the harmful effects of COVID-19 on the cardiovascular system. This systematic review aims to systematically analyze papers reporting echocardiographic findings in hospitalized COVID-19 subjects. Materials and methods We included prospective and retrospective studies reporting echocardiography data in >10 hospitalized adult subjects with COVID-19; from 1st February 2020 to 15th January 2021. Results The primary electronic search identified 1120 articles. Twenty-nine studies were finally included, enrolling 3944 subjects. Overall the studies included a median of 68.0% (45.5–100.0) of patients admitted to ICU. Ten studies (34.4%) were retrospective, and 20 (68.9%) single-centred. Overall enrolling 1367 subjects, three studies reported normal echocardiographic findings in 49 ± 18% of cases. Seven studies (24.1%) analyzed the association between echocardiographic findings and mortality, mostly related to right ventricular (RV) dysfunction. Conclusions Data regarding the use of echocardiography on hospitalized, predominantly ICU, COVID-19 patients were retrieved from studies with heterogeneous designs, variable sample sizes, and severity scores. Normal echocardiographic findings were reported in about 50% of subjects, with LVEF usually not affected. Overall, RV dysfunction seems more likely associated with increased mortality. Trial Registration CRD42020218439.

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Section: Discussionmentioning

confidence: 99%

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

Messina

Sanfilippo

Milani

et al. 2021

Journal of Critical Care

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“…Different phenotypes of cardiovascular dysfunction have been described in critically ill patients 34 , and LVDD has received attention for its association both with mortality in septic patients 21,22 and for weaning failure 23 . Conversely, LVSD has not shown the same association when evaluated by means of LVEF 35 or s' wave 24 in critically ill patients. It was somewhat unexpected to find that TDI s' wave was significantly lower in hospital (and ICU) non-survivors, as this parameter has not been found associated with prognosis in critically ill patients (i.e.…”

Section: Discussionmentioning

confidence: 84%

“…history of hypertension and diabetes) or acute deterioration of their LV diastolic function. Of note, in non-COVID-19 critically ill patients, left ventricular diastolic dysfunction (LVDD) has received attention for its association with outcomes [21][22][23] , while the same association has not been shown for left ventricular systolic dysfunction (LVSD) 24 . Echocardiography is crucial in diagnosing and grading LVDD and may help distinguishing patterns of cardiovascular dysfunction, suggesting therapeutic options, and tracking the changes with sequential monitoring 25 .…”

Section: Introductionmentioning

confidence: 99%

Full and simplified assessment of Left Ventricular Diastolic Function in Covid-19 Patients admitted to ICU: feasibility, incidence and association with mortality.

Via

Dezio

Santonocito

et al. 2022

Preprint

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Purpose: Left ventricular diastolic dysfunction (LVDD) is associated with poor outcomes in intensive care unit (ICU). Nonetheless, precise reporting of LVDD in COVID-19 patients is currently lacking and assessment could be challenging. Methods: We performed an echocardiography study in COVID-19 patients admitted to ICU with the aim to describe the feasibility of full or simplified LVDD assessment and its incidence. We also evaluated the association of LVDD or of single echocardiographic parameters with hospital mortality. Results: Between 06.10.2020 and 18.02.2021, full diastolic assessment was feasible in 74% (n=26/35) of patients receiving full echocardiogram study. LVDD incidence was 46% (n=12/26), whilst the assessment produced different results (incidence 81%, n=21/26). Nine patients were hospital-survivors (39%); incidence of LVDD (full assessment) was not different between survivors (n=2/9, 22%) and non-survivors (n=10/17, 59%; p=0.11). Also, the E/e’ ratio lateral was lower in survivors (7.4 [3.6] vs non-survivors 10.5 [6.3], p=0.03). We also found that s’ wave was higher in survivors (average, p=0.01). Conclusion: In a small single-center study, assessment of LVDD according to latest guidelines was feasible in three quarter of COVID-19 patients. Non-survivors showed a trend towards greater LVDD incidence; moreover, they had significantly worse s’ values (all) and higher E/e’ ratio (lateral).

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“…First of all, several meta-analyses have consistently shown that LVSD (as evaluated by means of EF 3,4 or tissue Doppler imaging s0 wave 5 ) is not associated with mortality in critically ill patients. Whether the inclusion of this and other new studies would affect this result remains unknown.…”

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Systolic dysfunction and mortality in critically ill patients: more data are needed to believe in this association!

et al. 2022

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We read with interest the large study conducted by Cavefors et al. 1 assessing the impact of left ventricular systolic dysfunction (LVSD) on mortality in critically ill patients. The authors defined LVSD as an ejection fraction (EF) < 50% and/or the presence of regional wall motion abnormalities (RWMA) and found a prevalence of 24% (n = 100) with roughly half of them (n = 52) experiencing an LVSD not attributable to a cardiac disease.

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Systolic dysfunction as evaluated by tissue Doppler imaging echocardiography and mortality in septic patients: A systematic review and meta-analysis

Cited by 36 publications

References 52 publications

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

COVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature

Full and simplified assessment of Left Ventricular Diastolic Function in Covid-19 Patients admitted to ICU: feasibility, incidence and association with mortality.

Systolic dysfunction and mortality in critically ill patients: more data are needed to believe in this association!

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