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Echocardiographic abnormalities and predictors of mortality in hospitalized COVID-19 patients: the ECHOVID-19 study.


ABSTRACT:

Aims

The present study had two aims: (i) compare echocardiographic parameters in COVID-19 patients with matched controls and (2) assess the prognostic value of measures of left (LV) and right ventricular (RV) function in relation to COVID-19 related death.

Methods and results

In this prospective multicentre cohort study, 214 consecutive hospitalized COVID-19 patients underwent an echocardiographic examination (by pre-determined research protocol). All participants were successfully matched 1:1 with controls from the general population on age, sex, and hypertension. Mean age of the study sample was 69 years, and 55% were male participants. LV and RV systolic function was significantly reduced in COVID-19 cases as assessed by global longitudinal strain (GLS) (16.4% ± 4.3 vs. 18.5% ± 3.0, P < 0.001), tricuspid annular plane systolic excursion (TAPSE) (2.0 ± 0.4 vs. 2.6 ± 0.5, P < 0.001), and RV strain (19.8 ± 5.9 vs. 24.2 ± 6.5, P = 0.004). All parameters remained significantly reduced after adjusting for important cardiac risk factors. During follow-up (median: 40 days), 25 COVID-19 cases died. In multivariable Cox regression reduced TAPSE [hazard ratio (HR) = 1.18, 95% confidence interval (CI) [1.07-1.31], P = 0.002, per 1 mm decrease], RV strain (HR = 1.64, 95%CI[1.02;2.66], P = 0.043, per 1% decrease) and GLS (HR = 1.20, 95%CI[1.07-1.35], P = 0.002, per 1% decrease) were significantly associated with COVID-19-related death. TAPSE and GLS remained significantly associated with the outcome after restricting the analysis to patients without prevalent heart disease.

Conclusions

RV and LV function are significantly impaired in hospitalized COVID-19 patients compared with matched controls. Furthermore, reduced TAPSE and GLS are independently associated with COVID-19-related death.

SUBMITTER: Lassen MCH 

PROVIDER: S-EPMC7755011 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Echocardiographic abnormalities and predictors of mortality in hospitalized COVID-19 patients: the ECHOVID-19 study.

Lassen Mats Christian Højbjerg MCH   Skaarup Kristoffer Grundtvig KG   Lind Jannie Nørgaard JN   Alhakak Alia Saed AS   Sengeløv Morten M   Nielsen Anne Bjerg AB   Espersen Caroline C   Ravnkilde Kirstine K   Hauser Raphael R   Schöps Liv Borum LB   Holt Eva E   Johansen Niklas Dyrby ND   Modin Daniel D   Djernaes Kasper K   Graff Claus C   Bundgaard Henning H   Hassager Christian C   Jabbari Reza R   Carlsen Jørn J   Lebech Anne-Mette AM   Kirk Ole O   Bodtger Uffe U   Lindholm Matias Greve MG   Joseph Gowsini G   Wiese Lothar L   Schiødt Frank Vinholt FV   Kristiansen Ole Peter OP   Walsted Emil Schwarz ES   Nielsen Olav Wendelboe OW   Madsen Birgitte Lindegaard BL   Tønder Niels N   Benfield Thomas T   Jeschke Klaus Nielsen KN   Ulrik Charlotte Suppli CS   Knop Filip Krag FK   Lamberts Morten M   Sivapalan Pradeesh P   Gislason Gunnar G   Marott Jacob Louis JL   Møgelvang Rasmus R   Jensen Gorm G   Schnohr Peter P   Søgaard Peter P   Solomon Scott D SD   Iversen Kasper K   Jensen Jens Ulrik Staehr JUS   Schou Morten M   Biering-Sørensen Tor T  

ESC heart failure 20201022 6


<h4>Aims</h4>The present study had two aims: (i) compare echocardiographic parameters in COVID-19 patients with matched controls and (2) assess the prognostic value of measures of left (LV) and right ventricular (RV) function in relation to COVID-19 related death.<h4>Methods and results</h4>In this prospective multicentre cohort study, 214 consecutive hospitalized COVID-19 patients underwent an echocardiographic examination (by pre-determined research protocol). All participants were successfull  ...[more]

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