Determining Which Hospitalized Coronavirus Disease 2019 Patients Require Urgent Echocardiography.
Determining Which Hospitalized Coronavirus Disease 2019 Patients Require Urgent Echocardiography.
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DOI：
10.1016/j.echo.2021.03.010
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Siegel RJ
中科院分区：
文献类型：
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作者：
Yuan N;Wu S;Rader F;Siegel RJ
Patients hospitalized with coronavirus disease 2019 (COVID-19) often have abnormal findings on transthoracic echocardiography (TTE). However, although not all abnormalities on TTE result in changes in clinical management, performing TTE in recently infected patients increases disease transmission risks. It remains unknown whether common biomarker tests, such as troponin and B-type natriuretic peptide (BNP), can help distinguish in which patients with COVID-19 TTE may be safely delayed until infection risks subside. Using electronic health records data and chart review, the authors retrospectively studied all patients hospitalized with COVID-19 in a multisite health care system from March 1, 2020, to January 15, 2021, who underwent TTE within 14 days of their first positive COVID-19 result and had BNP and troponin measured before or within 7 days of TTE. The primary outcome was the presence of one or more urgent echocardiographic findings, defined as left ventricular ejection fraction ≤ 35%, wall motion score index ≥ 1.5, moderate or greater right ventricular dysfunction, moderate or greater pericardial effusion, intracardiac thrombus, pulmonary artery systolic pressure > 50 mm Hg, or at least moderate to severe valvular disease. Stepwise logistic regression was conducted to determine biomarkers and comorbidities associated with the outcome. The performance of a rule for classifying TTE using troponin and BNP was evaluated. Four hundred thirty-four hospitalized and 151 intensive care unit patients with COVID-19 were included. Urgent findings on TTE were present in 105 patients (24.2%). Troponin and BNP were abnormal in 311 (71.7%). Heart failure (odds ratio, 5.41; 95% CI, 2.61–11.68), troponin > 0.04 ng/mL (odds ratio, 4.40; 95% CI, 2.05–10.05), and BNP > 100 pg/mL (odds ratio, 5.85; 95% CI, 2.35–16.09) remained significant predictors of urgent findings on TTE after stepwise selection. No urgent findings on TTE were seen in 95.1% of all patients and in 91.3% of intensive care unit patients with normal troponin and BNP. Troponin and BNP were highly associated with urgent echocardiographic findings and may be used in triaging algorithms for determining in which patients TTE can be safely delayed until after their peak infectious window has passed.
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DOI：
10.1016/j.echo.2020.10.009
发表时间：
2021-03
期刊：
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
影响因子：
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作者：
Catena C;Colussi G;Bulfone L;Da Porto A;Tascini C;Sechi LA
通讯作者：
Sechi LA
影响因子：
39.3
作者：
Bassan, R;Potsch, A;Moutinho, MA
通讯作者：
Moutinho, MA
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
5.7
作者：
Stefanini, Giulio G.;Chiarito, Mauro;Condorelli, Gianluigi
通讯作者：
Condorelli, Gianluigi
影响因子：
--
作者：
Shemisa, Kamal;Bhatt, Anish;Neeland, Ian J
通讯作者：
Neeland, Ian J