Background The novel coronavirus (SARS-CoV-2) has created global havoc by causing Coronavirus Disease 2019 (COVID-19). Cardiovascular involvement in COVID-19 varies from troponin rise or arrhythmia/myocarditis to fulminant cardiogenic shock. There is limited data on echocardiographic findings in such patients. We aimed to assess abnormal echocardiographic findings and contributory factors in patients with COVID-19.Methods We performed retrospective analysis of COVID-19 positive patients who underwent a transthoracic echocardiogram (TTE) at Sandwell and West Birmingham (SWBH) NHS Trust between March 2020 and May 2020. Patients were compared based on TTE changes and divided into two groups (abnormal TTE and normal TTE).Results 66 out of 463 patients with COVID-19 had a TTE. 46 patients (69.7%) had abnormal findings on their TTE. Tricuspid regurgitation was the most common abnormality observed (26 (56.5%) patients), followed by aortic regurgitation (13 (28.3%) patients) and mitral regurgitation (12 (26.1%) patients). Haemoglobin and LDH were predictors of abnormal TTE (Hb OR: 0.97, p = 0.049, LDH, OR: 1.00, p = 0.03). Significantly more patients in the abnormal TTE group died during their inpatient stay compared to normal TTE (p = 0.01). Having an abnormal TTE was an independent predictor of death on regression analysis (OR: 0.229, p = 0.034).Conclusions This is the first detailed observational study looking at echocardiographic changes in admitted COVID-19 patients irrespective of disease severity. The most common abnormality was valve regurgitation. Patients with abnormal TTE were more likely to die in hospital.

Background and Aims Single‐use electrocardiography (ECG) leads have been developed to reduce healthcare‐associated infection. This study compared the validity and reliability of short‐term heart rate variability (HRV) obtained from single‐use disposable ECG leads. Methods Thirty healthy subjects (33 ± 10 years; 9 females) underwent 5‐min resting HRV assessments using disposable (single use) ECG cable and wire system (Kendall DL™ Cardinal Health) and a standard, reusable ECG leads (CardioExpress, Spacelabs Healthcare). Results Intraclass correlation coefficient (ICC) with 95% confidence interval (CI) between disposable and reusable ECG leads was for the time domain [R‐R interval (ms); 0.99 (0.91, 1.00)], the root mean square of successive normal R‐R interval differences (RMSSD) (ms); 0.91 (0.76, 0.96), the SD of normal‐to‐normal R‐R intervals (SDNN) (ms); 0.91 (0.68, 0.97) and frequency domain [low‐frequency (LF) normalized units (nu); 0.90 (0.79, 0.95), high frequency (HF) nu; 0.91 (0.80, 0.96), LF power (ms 2 ); 0.89 (0.62, 0.96), HF power (ms 2 ); 0.90 (0.72, 0.96)] variables. The mean difference and upper and lower limits of agreement between disposable and reusable leads for time‐ and frequency‐domain variables were acceptable. Analysis of repeated measures using disposable leads demonstrated excellent reproducibility (ICC 95% CI) for R‐R interval (ms); 0.93 (0.85, 0.97), RMSSD (ms); 0.93 (0.85, 0.97), SDNN (ms); 0.88 (0.75, 0.95), LF power (ms 2 ); 0.87 (0.72, 0.94), and HF power (ms 2 ); 0.88 (0.73, 0.94) with coefficient of variation ranging from 2.2% to 5% ( p > 0.37 for all variables). Conclusion Single‐use Kendall DL™ ECG leads demonstrate a valid and reproducible tool for the assessment of HRV.

8 novice surgeons ranked their preferred grafting configuration for each of the 5 patients before and after being shown hemodynamic predictions. Results The use of 'COMCAB' led to a significant decrease in the selection of unsatisfactory anaortic grafting configurations by both experts (17.5% (7/40) vs 2.5% (1/40), P = 0.026) and novices (25% (10/40) vs 0% (0/40), P < 0.001). Novices were more likely than experts to change their rankings of preferred configurations following review of additional myocardial perfusion data (45% (36/80) vs 6.25% (5/80), P < 0.001) and more often selected grafting configurations that they previously indicated they would not use (36.54% (19/52) vs 2.63% (1/38), P < 0.001). Conclusion Based on these results, 'COMCAB' is a promising non-invasive tool utilising CTCA for improving surgical decision-making by avoiding unsatisfactory coronary grafts with inadequate flow and poor patency. Expert and novice coronary surgeons made improved decisions but used the predicted information in different ways.

No abstract