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| Clinical applications of diastolic dysfunction in light of the new guidelines in the intensive care unit |
| Li Jia, Wang Jin-rong |
| Department of Critical Care Medicine, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui 053000, China |
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Abstract There is growing evidence both in the perioperative period and in the field of intensive care (ICU) on the association between left ventricular diastolic dysfunction (LVDD) and worse outcomes in patients. In 2016, American Society of Echocardiography and European Association of Cardiovascular Imaging joint recommendations have tried to simplify the diagnosis and the grading of LVDD. However, both an often unknown pre morbid LV diastolic function and the presence of several confounders—i.e., use of vasopressors, positive pressure ventilation, volume loading—make the proposed parameters difficult to interpret, especially in the ICU. Among the proposed parameters for diagnosis and grading of LVDD, the two tissue Doppler imaging derived variables e′ and E/e′ seem most reliable. However, these are not devoid of limitations. In the present review, we aim at rationalizing the applicability of the recent recommendations to the ICU areas, discussing the clinical meaning and echocardiographic findings of different grades of LVDD, describing the impact of LVDD on patients′ outcomes and providing some hints on the management of patients with LVDD.
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Corresponding Authors:
Wang Jin-rong, E-mail: iamwjr306@163.com
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