Isolated diastolic dysfunction is associated with increased mortality in critically ill patients.

Area of Science:

• Cardiology
• Critical Care Medicine
• Echocardiography

Background:

• Left ventricular (LV) diastolic dysfunction is a significant factor in critically ill patients, yet its prevalence and impact on mortality remain understudied.
• Understanding diastolic function is vital for managing complex patient populations in intensive care units (ICUs).

Purpose of the Study:

• To determine the prevalence of left ventricular diastolic dysfunction in intensive care patients with normal LV systolic function.
• To explore the association between diastolic dysfunction and 90-day mortality in this patient cohort.

Main Methods:

• Echocardiography was performed within 24 hours of ICU admission.
• Patients were excluded if they had reduced LV ejection fraction, regional wall motion abnormalities, or pre-existing cardiac disease.
• Diastolic function was classified using the 2016 EACVI guidelines.

Main Results:

• Out of 218 patients, 74% had normal diastolic function, 10% had diastolic dysfunction, and 17% had indeterminate diastolic function.
• Diastolic dysfunction was more prevalent in female and older patients, and associated with sepsis, respiratory, and cardiovascular comorbidities.
• Patients with indeterminate or diastolic dysfunction had a significantly increased risk of 90-day mortality (OR 4.3 and 5.1, respectively) compared to those with normal diastolic function.

Conclusions:

• Isolated diastolic dysfunction, evaluated using a multi-parameter echocardiographic approach, is frequently observed in critically ill patients.
• The presence of diastolic dysfunction in ICU patients is a significant independent predictor of increased mortality.