ICU Hemodynamic Secrets:
You have probably seen this excellent study by @siddharth_dugar @AbhiDuggalMD (retrospective cohort study comprising all 3,151 adult patients admitted to the medical ICU with sepsis & septic shock)
You have probably seen this excellent study by @siddharth_dugar @AbhiDuggalMD (retrospective cohort study comprising all 3,151 adult patients admitted to the medical ICU with sepsis & septic shock)
The study showed that the association of LVEF to in-hospital mortality in sepsis and septic shock
was U-shaped
Both severe LV systolic dysfunction (LVEF < 25%) and hyperdynamic LVEF (LVEF ≥ 70%) were associated independently with significantly higher in-hospital mortality
was U-shaped
Both severe LV systolic dysfunction (LVEF < 25%) and hyperdynamic LVEF (LVEF ≥ 70%) were associated independently with significantly higher in-hospital mortality
It turns out that not just in the hospital but in the community world too, there is an entity of "heart failure with supra-normal EF". Among community-dwelling adults WITHOUT CVD, LVEF in the supra-normal range is associated w ⬆️ risk of adverse cardiovascular outcomes
Results are inconsistent in different cohorts but, in general, supranormal (sn) EF (HFsnEF), defined as LVEF ≥ 65%, seems to be a real enity and is associated with a higher risk of non-CV mortality but not all-cause mortality
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