Hyperdynamic left ventricular ejection fraction in the intensive care unit
Introduction Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patient...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BioMed Central
2021
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| Online Access: | https://hdl.handle.net/1721.1/136865 |
| _version_ | 1811068885627043840 |
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| author | Paonessa, Joseph R. Brennan, Thomas Pimentel, Marco Steinhaus, Daniel Feng, Mengling Celi, Leo A. |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Paonessa, Joseph R. Brennan, Thomas Pimentel, Marco Steinhaus, Daniel Feng, Mengling Celi, Leo A. |
| author_sort | Paonessa, Joseph R. |
| collection | MIT |
| description | Introduction
Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database.
Methods
We conducted a longitudinal, single-center, retrospective cohort study of adult patients who underwent echocardiography during a medical or surgical ICU admission at the Beth Israel Deaconess Medical Center using the Multiparameter Intelligent Monitoring in Intensive Care II database. The final cohort had 2867 patients, of whom 324 had HDLVEF, defined as an ejection fraction >70 %. Patients with an ejection fraction <55 % were excluded.
Results
Compared with critically ill patients with normal left ventricular ejection fraction, the finding of HDLVEF in critically ill patients was associated with female sex, increased age, and the diagnoses of hypertension and cancer. Patients with HDLVEF had increased 28-day mortality compared with those with normal ejection fraction in multivariate logistic regression analysis adjusted for age, sex, Sequential Organ Failure Assessment score, Elixhauser score for comorbidities, vasopressor use, and mechanical ventilation use (odds ratio 1.38, 95 % confidence interval 1.039–1.842, p =0.02).
Conclusions
The presence of HDLVEF portended increased 28-day mortality, and may be helpful as a gravity marker for prognosis in patients admitted to the ICU. Further research is warranted to gain a better understanding of how these patients respond to common interventions in the ICU and to determine if pharmacologic modulation of HDLVEF improves outcomes. |
| first_indexed | 2024-09-23T08:02:29Z |
| format | Article |
| id | mit-1721.1/136865 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T08:02:29Z |
| publishDate | 2021 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | mit-1721.1/1368652024-03-19T17:42:32Z Hyperdynamic left ventricular ejection fraction in the intensive care unit Paonessa, Joseph R. Brennan, Thomas Pimentel, Marco Steinhaus, Daniel Feng, Mengling Celi, Leo A. Massachusetts Institute of Technology. Institute for Medical Engineering & Science Introduction Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database. Methods We conducted a longitudinal, single-center, retrospective cohort study of adult patients who underwent echocardiography during a medical or surgical ICU admission at the Beth Israel Deaconess Medical Center using the Multiparameter Intelligent Monitoring in Intensive Care II database. The final cohort had 2867 patients, of whom 324 had HDLVEF, defined as an ejection fraction >70 %. Patients with an ejection fraction <55 % were excluded. Results Compared with critically ill patients with normal left ventricular ejection fraction, the finding of HDLVEF in critically ill patients was associated with female sex, increased age, and the diagnoses of hypertension and cancer. Patients with HDLVEF had increased 28-day mortality compared with those with normal ejection fraction in multivariate logistic regression analysis adjusted for age, sex, Sequential Organ Failure Assessment score, Elixhauser score for comorbidities, vasopressor use, and mechanical ventilation use (odds ratio 1.38, 95 % confidence interval 1.039–1.842, p =0.02). Conclusions The presence of HDLVEF portended increased 28-day mortality, and may be helpful as a gravity marker for prognosis in patients admitted to the ICU. Further research is warranted to gain a better understanding of how these patients respond to common interventions in the ICU and to determine if pharmacologic modulation of HDLVEF improves outcomes. 2021-11-01T14:33:52Z 2021-11-01T14:33:52Z 2015-12-01 2021-08-08T03:30:39Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/136865 Critical Care. 2015 Dec 01;19(1):288 PUBLISHER_CC en https://doi.org/10.1186/s13054-015-1012-8 Creative Commons Attribution https://creativecommons.org/licenses/by/4.0/ Paonessa et al. application/pdf BioMed Central BioMed Central |
| spellingShingle | Paonessa, Joseph R. Brennan, Thomas Pimentel, Marco Steinhaus, Daniel Feng, Mengling Celi, Leo A. Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title | Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title_full | Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title_fullStr | Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title_full_unstemmed | Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title_short | Hyperdynamic left ventricular ejection fraction in the intensive care unit |
| title_sort | hyperdynamic left ventricular ejection fraction in the intensive care unit |
| url | https://hdl.handle.net/1721.1/136865 |
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