Outcomes
Our primary outcomes were the feasibility of assessment of LVDD according to the latest ASE/EACVI 2016 recommendations20 and the incidence of LVDD according to these recommendations. In the current ASE/EACVI 2016 recommendations20, two TDI data (e’ wave velocity and E/e’ ratio) are combined with tricuspid regurgitation jet velocity (TRvel) and LAVI for diagnosing LVDD. For patients with established LVDD diagnosis (including those with depressed LV ejection fraction, LVEF), the values of E wave and E/A ratio are then considered in the algorithm for LVDD grading into grade I, II, and III. Considering the challenges in the application of these recommendations to the ICU setting in mechanically ventilated patients28,29, we also conducted an analysis on the assessment of LVDD according to the protocol suggested by Lanspa et al., which combines abnormal values of septal e’ (for the diagnosis of LVDD) with values of E/e’ ratio for the grading of LVDD itself30. As secondary outcomes we investigated the association between hospital mortality and the diagnosis of LVDD or each single echocardiographic variables collected for the study. A sensitivity analysis was conducted evaluating the ICU mortality.