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.