Diastolic dysfunction is a significant concern in critically ill patients admitted to the intensive care unit , and it has been associated with increased morbidity and mortality. The relationship between diastolic dysfunction and mortality in ICU patients is multifaceted and influenced by several factors. Diastolic dysfunction can lead to hemodynamic instability, making it harder to manage fluid balance and blood pressure in critically ill patients. Patients with diastolic dysfunction may have a limited ability to increase cardiac output in response to stress, leading to inadequate tissue perfusion. Poor cardiac relaxation and elevated filling pressures can contribute to multi-organ dysfunction, a common cause of mortality in ICU settings. Studies have shown that diastolic dysfunction is independently associated with higher mortality rates in ICU patients. The severity of diastolic dysfunction correlates with worse outcomes. ICU patients with diastolic dysfunction often have longer ICU and hospital stays, increased need for mechanical ventilation, and higher rates of complications. Addressing underlying conditions such as hypertension, diabetes, and sepsis can help improve diastolic function. Early detection and appropriate management of diastolic dysfunction, along with addressing underlying causes and careful hemodynamic monitoring, are essential to improve outcomes in these patients. Continued research and awareness are necessary to refine strategies for managing diastolic dysfunction in the ICU settings. I will be undertaking this study as very less number of studies have been done till date and to find out the association between diastolic dysfunction and mortality in critically ill ICU patients. Diastolic left ventricular (LV) dysfunction is associated with slow LV relaxation and increased LV stiffness. Cardiac dysfunction in critical care patients may contribute to multiorgan failure and increased mortality . Diastolic dysfunction can be the reason for intensive care unit (ICU) admission, or be a result from critical illness. Doppler echocardiographic assessment of early (E-wave) and late (A-wave) diastolic filling and the mitral annular early diastolic velocity (e’), as well as E/A and E/e’ ratios, have been used to diagnose diastolic dysfunction . Abnormal values with different cut-offs have been associated with worse outcomes and increased mortality. Sanfilippo F et al documented in patients with sepsis, diastolic dysfunction has a better correlation with mortality than left ventricular systolic dysfunction . Increased mortality is seen with sepsis patients with diastolic dysfunction and higher grades with worst outcomes . Lanspa et al proposed a simple definition for diastolic dysfunction based on Echo . According to this definition, patients with e’sep < 8 are diagnosed to have diastolic dysfunction. They are further graded based on E/e’; < 8, patients are classified as grade 1; 8–13, patients are classified as grade 2; and if over 13, patients are classified as grade 3 .These parameters outperformed ASE American Society of Echocardiography 2009 and 2016 guidelines for diastolic dysfunction . Diastolic dysfunction could be more prevalent in patients with more advanced disease or be a part of multiorgan failure with an associated increase in mortality. Patients with diastolic dysfunction have lower PaO2/FiO2 secondary to pulmonary congestion caused by higher filling pressures , which has been shown to lead to extubation failure . |