Study Limitations
This is a single-center study with a small sample size and a
cross-sectional design. A variety of demographic conditions and diseases
can affect CFVR, and while there were no significant differences between
groups at baseline, such effects of confounders cannot be completely
overruled. Biomarker concentrations were not obtained synchronously with
the echocardiographic CFVR measurement in many patients. However,
exposing a critically ill patient to a drug that could deteriorate her
condition would be unethical, and an echocardiographic examination was
performed as soon as possible. As correlation does not imply causality,
present findings do not show that inflammation or prothrombotic milieu
causes CFVR or CFVR leads to myocardial injury but rather suggests an
association between them. Also, elevation of an inflammatory /
thrombotic biomarker does not show an organ-specific condition but
rather reflects an overall inflammatory or prothrombotic state. Thus,
present findings should be interpreted in this context.