Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography.
Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography.
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使用二维斑点追踪超声心动图通过心肌应变成像检测出 COVID-19 患者广泛的心肌功能障碍
DOI：
10.1038/s41401-020-00595-z
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发表时间：
2021-10
影响因子：
8.2
通讯作者：
Wang DW
中科院分区：
文献类型：
--
作者：
Li R;Wang H;Ma F;Cui GL;Peng LY;Li CZ;Zeng HS;Marian AJ;Wang DW
COVID-19是由SARS-CoV-2病毒引起的多器官系统性炎症性疾病。COVID-19患者经常表现出心功能不全和心肌损伤，但缺乏影像学证据。在这项研究中，我们使用二维斑点追踪超声心动图（2-D STE）检测并评估了COVID-19患者人群的心肌功能障碍严重程度。共有218名确诊为COVID-19且无基础心血管疾病的连续患者入组并接受了经胸超声心动图检查。该研究队列包括52例（23.8%）危重患者和166例非危重患者。使用2-D STE获得全局纵向应变（GLS）和层特异性纵向应变（LSLS）。GLS的变化与临床参数相关。我们发现约83%的患者GLS减少（<-21.0%）。GLS减少在危重患者中更为常见（98% vs. 78.3%，P < 0.001），危重患者的平均GLS显著低于非危重患者（−13.7% ± 3.4% vs. −17.4% ± 3.2%，P < 0.001）。GLS在心外膜下的变化较心内膜下显著（P< 0.001）。GLS与平均血清脉搏血氧饱和度（SpO 2，RR = 0.42，P < 0.0001）、超敏C反应蛋白（hsCRP，R=-0.20，P = 0.006）和炎性细胞因子，尤其是IL-6（R=-0.21，P = 0.003）相关。总之，我们的研究结果表明，心肌功能障碍在COVID-19患者中很常见，特别是那些重症患者。心肌应变指数的变化与炎症标志物和缺氧指数相关，提示部分继发性心肌功能障碍。
COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus. Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury, but imaging evidence is lacking. In the study we detected and evaluated the severity of myocardial dysfunction in COVID-19 patient population using two-dimensional speckle-tracking echocardiography (2-D STE). A total of 218 consecutive patients with confirmed diagnosis of COVID-19 who had no underlying cardiovascular diseases were enrolled and underwent transthoracic echocardiography. This study cohort included 52 (23.8%) critically ill and 166 noncritically ill patients. Global longitudinal strains (GLSs) and layer-specific longitudinal strains (LSLSs) were obtained using 2-D STE. Changes in GLS were correlated with the clinical parameters. We showed that GLS was reduced (<−21.0%) in about 83% of the patients. GLS reduction was more common in critically sick patients (98% vs. 78.3%,P< 0.001), and the mean GLS was significantly lower in the critically sick patients than those noncritical (−13.7% ± 3.4% vs. −17.4% ± 3.2%,P< 0.001). The alteration of GLS was more prominent in the subepicardium than in the subendocardium (P< 0.001). GLS was correlated to mean serum pulse oxygen saturation (SpO2, RR = 0.42,P< 0.0001), high-sensitive C-reactive protein (hsCRP,R= −0.20,P= 0.006) and inflammatory cytokines, particularly IL-6 (R= −0.21,P= 0.003). In conclusions, our results demonstrate that myocardial dysfunction is common in COVID-19 patients, particularly those who are critically sick. Changes in indices of myocardial strain were associated with indices of inflammatory markers and hypoxia, suggesting partly secondary nature of myocardial dysfunction.
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影响因子：
6.2
作者：
Montgomery, David E.;Puthumana, Jyothy J.;Ogunyankin, Kofo O.
通讯作者：
Ogunyankin, Kofo O.
影响因子：
9.8
作者：
Ackland, G. L.;Abbott, T. E. F.;Pearse, R. M.
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Pearse, R. M.
影响因子：
6.5
作者：
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通讯作者：
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影响因子：
24
作者：
Inciardi, Riccardo M.;Lupi, Laura;Metra, Marco
通讯作者：
Metra, Marco
DOI：
10.1016/j.echo.2011.03.007
发表时间：
2011-07-01
影响因子：
6.5
作者：
Shimoni, Sara;Gendelman, Gera;Friedman, Zvi
通讯作者：
Friedman, Zvi