Response to “Left Ventricular Longitudinal Function and Hyperkinetic Profile: A New Echocardiographic Area for Exploration?”

Category	Detail
Condition	Hyperdynamic left ventricular ejection fraction and longitudinal systolic function during critical illness
Key Mechanisms	The analyses compare LVEF with global longitudinal strain (GLS), mitral annular plane systolic excursion (MAPSE), and S′; the authors note these measures may not represent identical physiological processes.
Target Population	Patients in a mixed intensive care unit cohort with available LVEF and longitudinal systolic measurements
Care Setting	Critical care echocardiography in the intensive care unit

Among patients with available LVEF, 48 (17%) had LVEF >70% and 177 (61%) had LVEF 50–70%.
Ninety-day mortality was 27% with LVEF >70% and 23% with LVEF 50–70%; the adjusted difference was not statistically significant (OR 1.36, 95% CI 0.55–3.37; p=0.501).
The LVEF >70% group had greater absolute GLS magnitude and modestly higher MAPSE; S′ did not differ significantly between groups.
No distinct MAPSE, GLS, or S′ threshold corresponding to hyperdynamic LVEF was identified.
High-value GLS, MAPSE, and S′ groups were not associated with 90-day mortality in unadjusted or adjusted analyses.

The article reports exploratory comparisons using LVEF >70% to define the hyperdynamic group and LVEF 50–70% as the comparison group.
No distinct longitudinal systolic marker threshold corresponding to a hyperdynamic LVEF profile was identified.

The authors support further examination of hyperdynamic LV phenotype in relation to longitudinal myocardial function, haemodynamic characteristics, and clinical outcomes.

Interpret the mortality analyses cautiously: they were exploratory and included few patients with a hyperdynamic phenotype.
The mortality difference between LVEF groups was not statistically significant, and none of the high-value longitudinal marker groups was associated with 90-day mortality.

Mixed ICU cohort; 48 patients had LVEF >70% and 177 had LVEF 50–70% among those with available LVEF.

No prescribing or treatment data are reported.

Do not assume that preserved or elevated LVEF invariably indicates normal myocardial physiology.
Interpret the reported associations as exploratory; the authors state that the findings require cautious interpretation.
Consider LVEF and longitudinal systolic measurements as distinct measures; the analyses did not identify a matching hyperdynamic longitudinal profile.

Clinical Scorecard: Response to “Left Ventricular Longitudinal Function and Hyperkinetic Profile: A New Echocardiographic Area for Exploration?”