Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug 7;19(1):288.
doi: 10.1186/s13054-015-1012-8.

Hyperdynamic left ventricular ejection fraction in the intensive care unit

Joseph R Paonessa  1   2   3 , Thomas Brennan  4 , Marco Pimentel  5 , Daniel Steinhaus  6   7 , Mengling Feng  8 , Leo Anthony Celi  9   10   11
Affiliations

Hyperdynamic left ventricular ejection fraction in the intensive care unit

Joseph R Paonessa et al. Crit Care. .

Abstract

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.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram showing initial selection of cohort and excluded patients. CSRU cardiac surgical resuscitation unit, HDLVEF hyperdynamic left ventricular ejection fraction on echocardiogram, LVEF left ventricular ejection fraction, MICU medical intensive care unit, SICU surgical intensive care unit, TTE transthoracic echocardiography
See this image and copyright information in PMC

References

    1. American College of Cardiology. Left ventricular ejection fraction LVEF assessment. http://www.acc.org/tools-and-practice-support/clinical-toolkits/heart-fa.... Accessed 2 August 2015.
    1. Groeneveld ABJ, Nauta JJ, Thijs L. Peripheral vascular resistance in septic shock: its relation to outcome. Intensive Care Med. 1988;14:141–7. doi: 10.1007/BF00257468. - DOI - PubMed
    1. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Hemodynamic instability in sepsis: bedside assessment by Doppler echocardiography. Am J Respir Crit Care Med. 2003;168:1270–6. doi: 10.1164/rccm.200306-816CC. - DOI - PubMed
    1. Thierry S, Giroux Leprieur E, Lecuyer L, Brocas E, Van de Louw A. Echocardiographic features, mortality, and adrenal function in patients with cirrhosis and septic shock. Acta Anaesthesiol Scand. 2008;52:45–51. doi: 10.1111/j.1399-6576.2007.01491.x. - DOI - PubMed
    1. Jones AE, Craddock PA, Tayal VS, Kline JA. Diagnostic accuracy of left ventricular function for identifying sepsis among emergency department patients with nontraumatic symptomatic undifferentiated hypotension. Shock. 2005;24:513–7. doi: 10.1097/01.shk.0000186931.02852.5f. - DOI - PubMed

Publication types

Substances

LinkOut - more resources