Association of Right Ventricular Dilation on Echocardiogram With In-Hospital Mortality Among Patients Hospitalized With COVID-19 Compared With Bacterial Pneumonia

Sun, Kaiwen; Cedarbaum, Emily R; Hill, Christopher A.; Win, Sithu; Parikh, Nisha I.; Hsue, Priscilla Y.; Durstenfeld, Matthew S

doi:10.1016/j.echo.2022.12.019

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Thirdly, it was highlighted that patients with isolated RV dilation on ICU admission had a higher mortality rate than patients with RV systolic dysfunction regardless of RV dilation. This result is consistent with the existing literature, which has shown that early isolated RV dilation is associated with in-hospital mortality in patients with COVID-19 [ 3 ]. As suggested by Dr DANDEL, this early isolated RV dilation could illustrate a lower RV adaptability to increased RV afterload, thus explaining this poorer prognosis.…”

supporting

confidence: 93%

Rebuttal to the letter “Assessment of COVID-19-related right ventricular morphological and functional alterations and evaluation of their impact on the course of the disease”

Jozwiak

2024

Ann. Intensive Care

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supporting

confidence: 93%

Rebuttal to the letter “Assessment of COVID-19-related right ventricular morphological and functional alterations and evaluation of their impact on the course of the disease”

Jozwiak

2024

Ann. Intensive Care

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“…Sun et al 31 demonstrated similar prevalences of RVD among COVID-19 pneumonia and bacterial pneumonia. Their prevalences were lower than ours and may be explained by the use of traditional parameters of TAPSE and RVS’.…”

Section: Discussionmentioning

confidence: 86%

“…It is difficult to ascertain the true degree of RVD that occurs specifically due to COVID-19 hypoxic pneumonia owing to the confounding effects of disease severity, varying P/F ratios, clinical settings (hospitalized vs. intensive care), and variability in the timing of echocardiography with regard disease progression, however, the prevalence of RVFWS is reported to vary between 12.6% 31 , 32 and 86%. 26 …”

Section: Discussionmentioning

confidence: 99%

Right heart echocardiography findings in hypoxic pneumonia patients during the COVID-19 pandemic in a South African population

van Blydenstein,

Omar,

Jacobson

et al. 2023

European Heart Journal - Imaging Methods and Practice

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Aims The right ventricle is affected by Coronavirus disease 19 (COVID-19) via multiple mechanisms, which can result in right ventricular dysfunction (RVD). This study aimed to provide an assessment of right heart function using conventional echocardiography and advanced strain imaging, in patients with hypoxic pneumonia during the COVID-19 pandemic. Methods and results This study was an observational, prospective, single-centre study, including adults with hypoxic pneumonia, in two groups: COVID-19 pneumonia; and non-COVID-19 pneumonia. Bedside echocardiography was performed according to a pre-specified protocol and all right heart measurements were done as per standard guidelines. Right ventricular free wall strain (RVFWS) was measured using Philips® QLAB 11.0 speckle tracking software. Descriptive and comparative statistics were used to analyse data. Spearman Rank Order Correlations were used to determine the correlation between right ventricular (RV) parameters and clinical parameters. Univariate and multivariate logistic regression analyses were performed to characterize the predictors of in-hospital mortality. We enrolled 48 patients with COVID-19 pneumonia and 24 with non-COVID-19 pneumonia. COVID-19 patients were significantly older with a higher frequency of hypertension and diabetes and a trend towards a lower severity of illness score. Mean RVFWS yielded the highest estimates for the prevalence of RVD (81%), with no difference between the two pneumonia groups. Median Tricuspid Annular Plane Systolic Excursion (TAPSE) and right ventricular systolic excursion velocity (RVS’) were not significantly different between COVID-19 (TAPSE 17.2 and RVS’ 12), and non-COVID-19 pneumonia (TAPSE 17.8 and RVS’ 12.1) with P values of 0.29 and 0.86, respectively. Non-COVID-19 pneumonia patients with moderate to severe hypoxaemia (PF < 150) were at greater risk of an elevated RV Systolic Pressure >30 mmHg respiratory rate = 3.25 (CI 1.35–7.82) on admission. Troponin levels discriminated between COVID-19 survivors (6 ng/L) and non-survivors (13 ng/L), P = 0.04. The mortality rate for COVID-19 was high (27%) compared to non-COVID-19 pneumonia (12%). Conclusion Patients with COVID-19 pneumonia had a similar admission prevalence of RVD when compared to patients with non-COVID-19 pneumonia. Despite preserved traditional parameters of RV systolic function, RVFWS was diminished in both groups, and we propose that RVFWS serves as an important marker of the subclinical disease of RV.

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Right Ventricular Dilation on Echocardiogram: An Early Indication of Higher In-Hospital Mortality Risk Among Patients With SARS-CoV-2 Pneumonia

Dandel

2023

Journal of the American Society of Echocardiography

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Association of Right Ventricular Dilation on Echocardiogram With In-Hospital Mortality Among Patients Hospitalized With COVID-19 Compared With Bacterial Pneumonia

Cited by 3 publications

References 7 publications

Rebuttal to the letter “Assessment of COVID-19-related right ventricular morphological and functional alterations and evaluation of their impact on the course of the disease”

Rebuttal to the letter “Assessment of COVID-19-related right ventricular morphological and functional alterations and evaluation of their impact on the course of the disease”

Right heart echocardiography findings in hypoxic pneumonia patients during the COVID-19 pandemic in a South African population

Right Ventricular Dilation on Echocardiogram: An Early Indication of Higher In-Hospital Mortality Risk Among Patients With SARS-CoV-2 Pneumonia

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