Prevalence of cardiac pathology and relation to mortality in a multiethnic population hospitalised with COVID-19.
Prevalence of cardiac pathology and relation to mortality in a multiethnic population hospitalised with COVID-19.
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DOI：
10.1136/openhrt-2021-001833
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发表时间：
2021-11
期刊：
影响因子：
2.7
通讯作者：
Senior R
中科院分区：
文献类型：
--
作者：
Bioh G;Botrous C;Howard E;Patel A;Hampson R;Senior R
确定因 COVID-19 入院的患者心脏异常的患病率及其与心肌损伤和死亡率标志物的关系。一项回顾性和前瞻性观察性研究，针对伦敦 NHS 信托机构内因 COVID-19 疑似心脏病而转诊接受经胸超声心动图检查的住院患者。进行超声心动图评估左心室 (LV)、右心室 (RV) 和肺部变量，并收集患者人口统计数据、合并症、血液生物标志物和结果。在主要非白人 (72%) 人群中，50% 的患者注意到右心室功能障碍是主要的心脏异常，右心室面积分数变化 <35% 是这种右心室功能障碍的最常见标志。相比之下，18% 的患者出现左室收缩功能障碍。右心室功能障碍与左心室收缩功能障碍以及整个心动周期中 D 形左心室的存在（显着肺动脉高压的标志）相关。左心室收缩功能障碍（p=0.002，HR 3.82，95% CI 1.624 至 8.982）、肺动脉瓣加速时间（p=0.024，HR 0.98，95% CI 0.964 至 0.997）——肺血管阻力增加的标志、年龄（p=0.047，HR 1.027， 95%CI 1.000 至 1.055）和从入院到出现回波时间测量的心动过速发作（p=0.004，HR 6.183，95% CI 1.772 至 21.575）与死亡率独立相关。在因 COVID-19 住院的以非白人为主的人群中，最常见的心脏病理学是右心室功能障碍，这与左心室收缩功能障碍和肺动脉压升高有关。后两者（而非右心室功能障碍）与死亡率相关。
To determine the prevalence of cardiac abnormalities and their relationship to markers of myocardial injury and mortality in patients admitted to hospital with COVID-19. A retrospective and prospective observational study of inpatients referred for transthoracic echocardiography for suspected cardiac pathology due to COVID-19 within a London NHS Trust. Echocardiograms were performed to assess left ventricular (LV), right ventricular (RV) and pulmonary variables along with collection of patient demographics, comorbid conditions, blood biomarkers and outcomes. In the predominant non-white (72%) population, RV dysfunction was the primary cardiac abnormality noted in 50% of patients, with RV fractional area change <35% being the most common marker of this RV dysfunction. By comparison, LV systolic dysfunction occurred in 18% of patients. RV dysfunction was associated with LV systolic dysfunction and the presence of a D-shaped LV throughout the cardiac cycle (marker of significant pulmonary artery hypertension). LV systolic dysfunction (p=0.002, HR 3.82, 95% CI 1.624 to 8.982), pulmonary valve acceleration time (p=0.024, HR 0.98, 95% CI 0.964 to 0.997)—marker of increased pulmonary vascular resistance, age (p=0.047, HR 1.027, 95% CI 1.000 to 1.055) and an episode of tachycardia measured from admission to time of echo (p=0.004, HR 6.183, 95% CI 1.772 to 21.575) were independently associated with mortality. In this predominantly non-white population hospitalised with COVID-19, the most common cardiac pathology was RV dysfunction which is associated with both LV systolic dysfunction and elevated pulmonary artery pressure. The latter two, not RV dysfunction, were associated with mortality.
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1016/s2213-2600(20)30370-2
发表时间：
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期刊：
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影响因子：
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