Echocardiographic abnormalities and predictors of mortality in hospitalized COVID-19 patients: the ECHOVID-19 study.
Echocardiographic abnormalities and predictors of mortality in hospitalized COVID-19 patients: the ECHOVID-19 study.
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DOI：
10.1002/ehf2.13044
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发表时间：
2020-12
影响因子：
3.8
通讯作者：
Biering-Sørensen T
中科院分区：
文献类型：
--
作者：
Lassen MCH;Skaarup KG;Lind JN;Alhakak AS;Sengeløv M;Nielsen AB;Espersen C;Ravnkilde K;Hauser R;Schöps LB;Holt E;Johansen ND;Modin D;Djernaes K;Graff C;Bundgaard H;Hassager C;Jabbari R;Carlsen J;Lebech AM;Kirk O;Bodtger U;Lindholm MG;Joseph G;Wiese L;Schiødt FV;Kristiansen OP;Walsted ES;Nielsen OW;Madsen BL;Tønder N;Benfield T;Jeschke KN;Ulrik CS;Knop FK;Lamberts M;Sivapalan P;Gislason G;Marott JL;Møgelvang R;Jensen G;Schnohr P;Søgaard P;Solomon SD;Iversen K;Jensen JUS;Schou M;Biering-Sørensen T
本研究有两个目的：(i) 比较 COVID-19 患者与匹配对照组的超声心动图参数；(2) 评估左心室 (LV) 和右心室 (RV) 功能测量值与 COVID-19 相关死亡的预后价值。在这项前瞻性多中心队列研究中，214 名连续住院的 COVID-19 患者接受了超声心动图检查（按照预先确定的研究方案）。所有参与者均与普通人群中的对照组在年龄、性别和高血压方面成功进行了 1:1 匹配。研究样本的平均年龄为 69 岁，其中 55% 是男性参与者。根据整体纵向应变（GLS）（16.4% ± 4.3 vs. 18.5% ± 3.0，P < 0.001）、三尖瓣环平面收缩偏移（TAPSE）（2.0 ± 0.4 vs. 2.6 ± 0.5， P < 0.001）和 RV 应变（19.8 ± 5.9 与 24.2 ± 6.5，P = 0.004）。在调整重要的心脏危险因素后，所有参数仍然显着降低。在随访期间（中位时间：40 天），25 例 COVID-19 病例死亡。在多变量 Cox 回归中，减少了 TAPSE [风险比 (HR) = 1.18，95% 置信区间 (CI) [1.07–1.31]，P = 0.002，每减少 1 mm]、RV 应变（HR = 1.64，95% CI[1.02;2.66]，P = 0.043，每减少 1%）和 GLS （HR=1.20，95%CI[1.07–1.35]，P=0.002，每下降 1%）与 COVID-19 相关死亡显着相关。将分析限制在没有流行心脏病的患者后，TAPSE 和 GLS 仍然与结果显着相关。与匹配的对照组相比，住院的 COVID-19 患者的右心室和左心室功能显着受损。此外，TAPSE 和 GLS 减少与 COVID-19 相关死亡独立相关。
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. 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. 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.
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