Outcomes
Our primary outcomes were the feasibility of assessment of LVDD
according to the latest ASE/EACVI 2016
recommendations20 and
the incidence of LVDD according to these recommendations. In the current
ASE/EACVI 2016
recommendations20, two
TDI data (e’ wave velocity and E/e’ ratio) are combined with tricuspid
regurgitation jet velocity (TRvel) and LAVI for diagnosing LVDD. For
patients with established LVDD diagnosis (including those with depressed
LV ejection fraction, LVEF), the values of E wave and E/A ratio are then
considered in the algorithm for LVDD grading into grade I, II, and III.
Considering the challenges in the application of these recommendations
to the ICU setting in mechanically ventilated
patients28,29,
we also conducted an analysis on the assessment of LVDD according to the
protocol suggested by Lanspa et al., which combines abnormal values of
septal e’ (for the diagnosis of LVDD) with values of E/e’ ratio for the
grading of LVDD
itself30. As secondary
outcomes we investigated the association between hospital mortality and
the diagnosis of LVDD or each single echocardiographic variables
collected for the study. A sensitivity analysis was conducted evaluating
the ICU mortality.