Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study.
Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study.
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DOI：
10.1016/j.echo.2021.05.010
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
WASE-COVID Investigators
中科院分区：
文献类型：
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作者：
Karagodin I;Carvalho Singulane C;Woodward GM;Xie M;Tucay ES;Tude Rodrigues AC;Vasquez-Ortiz ZY;Alizadehasl A;Monaghan MJ;Ordonez Salazar BA;Soulat-Dufour L;Mostafavi A;Moreo A;Citro R;Narang A;Wu C;Descamps T;Addetia K;Lang RM;Asch FM;WASE-COVID Investigators
导致2019年全球冠状病毒病（COVID-19）大流行的新型严重急性呼吸系统综合征冠状病毒2型病毒已知通过多种机制对心血管系统产生不利影响。在这项由世界超声心动图联盟进行的国际多中心研究中，我们旨在确定COVID-19患者急性心脏病的临床和超声心动图表型，探索世界不同地理区域的表型差异，并确定与住院死亡率相关的参数。我们研究了来自世界四个地区（亚洲、欧洲、美国、拉丁美洲）13个医疗中心的870名急性COVID-19感染患者，这些患者接受了经胸超声心动图检查。收集临床和实验室数据，包括患者结局。使用自动化的机器学习算法分析的超声心动图，以计算左心室（LV）容积、射血分数和LV纵向应变（LS）。测量的右侧超声心动图参数包括右心室（RV）LS、RV自由壁应变（FWS）和RV基底直径。进行多变量回归分析，以确定与住院死亡率相关的临床和超声心动图参数。在患者合并症、疾病严重程度、临床生物标志物以及LV和RV超声心动图指标方面观察到显著的区域差异。总住院死亡率为21.6%。多变量分析中与死亡率相关的参数为年龄（比值比[OR] = 1.12 [1.05，1.22]，P = .003），既往肺部疾病（OR = 7.32 [1.56，42.2]，P = .015），LVLS（OR = 1.18 [1.05，1.36]，P = .012），乳酸脱氢酶（OR = 6.17 [1.74，28.7]，P = .009），RVFWS（OR = 1.14 [1.04，1.26]，P = .007）。在急性COVID-19疾病患者中，约20%的患者出现左心室功能障碍，约30%的患者出现右心室功能障碍，这预示着预后不良。就诊年龄、既往肺部疾病、乳酸脱氢酶、LVLS和RVFWS与住院死亡率独立相关。心脏表型的区域差异突出了世界不同地区患者急性程度和超声心动图利用率的显著差异。
The novel severe acute respiratory syndrome coronavirus-2 virus, which has led to the global coronavirus disease-2019 (COVID-19) pandemic is known to adversely affect the cardiovascular system through multiple mechanisms. In this international, multicenter study conducted by the World Alliance Societies of Echocardiography, we aim to determine the clinical and echocardiographic phenotype of acute cardiac disease in COVID-19 patients, to explore phenotypic differences in different geographic regions across the world, and to identify parameters associated with in-hospital mortality. We studied 870 patients with acute COVID-19 infection from 13 medical centers in four world regions (Asia, Europe, United States, Latin America) who had undergone transthoracic echocardiograms. Clinical and laboratory data were collected, including patient outcomes. Anonymized echocardiograms were analyzed with automated, machine learning–derived algorithms to calculate left ventricular (LV) volumes, ejection fraction, and LV longitudinal strain (LS). Right-sided echocardiographic parameters that were measured included right ventricular (RV) LS, RV free-wall strain (FWS), and RV basal diameter. Multivariate regression analysis was performed to identify clinical and echocardiographic parameters associated with in-hospital mortality. Significant regional differences were noted in terms of patient comorbidities, severity of illness, clinical biomarkers, and LV and RV echocardiographic metrics. Overall in-hospital mortality was 21.6%. Parameters associated with mortality in a multivariate analysis were age (odds ratio [OR] = 1.12 [1.05, 1.22], P = .003), previous lung disease (OR = 7.32 [1.56, 42.2], P = .015), LVLS (OR = 1.18 [1.05, 1.36], P = .012), lactic dehydrogenase (OR = 6.17 [1.74, 28.7], P = .009), and RVFWS (OR = 1.14 [1.04, 1.26], P = .007). Left ventricular dysfunction is noted in approximately 20% and RV dysfunction in approximately 30% of patients with acute COVID-19 illness and portend a poor prognosis. Age at presentation, previous lung disease, lactic dehydrogenase, LVLS, and RVFWS were independently associated with in-hospital mortality. Regional differences in cardiac phenotype highlight the significant differences in patient acuity as well as echocardiographic utilization in different parts of the world.
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Goldman ME
DOI：
10.1016/j.jcmg.2018.07.005
发表时间：
2018-08
期刊：
JACC. Cardiovascular imaging
影响因子：
--
作者：
Yang H;Wright L;Negishi T;Negishi K;Liu J;Marwick TH
通讯作者：
Marwick TH