Key result
Left ventricular diastolic dysfunction was present in 59% of non-survivors versus 22% of survivors among COVID-19 ICU patients (p=0.11), with non-survivors showing significantly worse s' and E/e'.
Why the study?
Left ventricular diastolic dysfunction is linked to poor ICU outcomes, but precise reporting in COVID-19 patients is lacking and its assessment can be challenging.
Observational (n=35)
No
Full echocardiographic assessment of diastolic function is feasible in most COVID-19 ICU patients, and specific parameters like higher E/e' ratio and lower s' wave are associated with hospital mortality.
Answers are grounded in this paper and cite their sources.
LVDD assessment feasibility in COVID-19 ICU patients requires confirmation; leaves open routine adoption and outcome associations without larger validation.
PURPOSE: Left ventricular diastolic dysfunction (LVDD) is associated with poor outcomes in the 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 a full echocardiogram study. LVDD incidence was 46% (n = 12/26), while the simplified assessment produced different results (incidence 81%, n = 21/26). Nine patients with normal function on full assessment had LVDD with simplified criteria (grade I = 2; grade II = 3; grade III = 4). Nine patients were hospital-survivors (39%); the incidence of LVDD (full assessment) was not different between survivors (n = 2/9, 22%) and non-survivors (n = 10/17, 59%; p = .11). The E/e' ratio lateral was lower in survivors (7.4 [3.6] vs. non-survivors 10.5 [6.3], p = .03). We also found that s' wave was higher in survivors (average, p = .01). CONCLUSION: In a small single-center study, assessment of LVDD according to the latest guidelines was feasible in three quarters of COVID-19 patients. Non-survivors showed a trend toward greater LVDD incidence; moreover, they had significantly worse s' values (all) and higher E/e' ratio (lateral).
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Via et al. (2022) conducted an observational in COVID-19 (n=35). Left ventricular diastolic dysfunction (LVDD) vs. Normal left ventricular diastolic function was evaluated on Hospital mortality (reported as LVDD incidence in non-survivors vs survivors) (p=.11). Left ventricular diastolic dysfunction was present in 59% of non-survivors versus 22% of survivors among COVID-19 ICU patients (p=0.11), with non-survivors showing significantly worse s' and E/e'.
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