Impaired Right Ventricular Longitudinal Strain Without Pulmonary Hypertension in Patients Who Have Recovered From COVID-19

Nuzzi, Vincenzo; Castrichini, Matteo; Collini, Valentino; Roman-Pognuz, Erik; Bella, Stefano Di; Luzzati, Roberto; Berlot, Giorgio; Confalonieri, Marco; Merlo, Marco; Stolfo, Davide; Sinagra, Gianfranco

doi:10.1161/circimaging.120.012166

Cited by 26 publications

(26 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is a retrospective analysis based on a multicentre study; therefore, some patients were excluded due to the absence of a second troponin assessment or because they experienced a fatal outcome within 48 h. Despite the absence of relevant differences in most of clinical and laboratory parameters between the study population and the excluded patients partially overcame this limitation, a selection bias still exists, represented by the choice of the clinician to perform a second troponin assay in selected patients. Moreover, despite recent reports that suggest a possible persistent cardiac involvement after COVID-19, 23,24 we could not follow the trend of troponin during the whole hospitalization period neither after discharge, focusing our attention just on the first 2 days. We had not the highest serum concentration of troponin systematically available amongst the measurements performed between 24 and 48 h, due to the retrospective nature and the design of the study.…”

Section: Limitationsmentioning

confidence: 87%

The prognostic value of serial troponin measurements in patients admitted for COVID‐19

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aims Myocardial injury (MI) in coronavirus disease‐19 (COVID‐19) is quite prevalent at admission and affects prognosis. Little is known about troponin trajectories and their prognostic role. We aimed to describe the early in‐hospital evolution of MI and its prognostic impact. Methods and results We performed an analysis from an Italian multicentre study enrolling COVID‐19 patients, hospitalized from 1 March to 9 April 2020. MI was defined as increased troponin level. The first troponin was tested within 24 h from admission, the second one between 24 and 48 h. Elevated troponin was defined as values above the 99th percentile of normal values. Patients were divided in four groups: normal, normal then elevated, elevated then normal, and elevated. The outcome was in‐hospital death. The study population included 197 patients; 41% had normal troponin at both evaluations, 44% had elevated troponin at both assessments, 8% had normal then elevated troponin, and 7% had elevated then normal troponin. During hospitalization, 49 (25%) patients died. Patients with incident MI, with persistent MI, and with MI only at admission had a higher risk of death compared with those with normal troponin at both evaluations ( P < 0.001). At multivariable analysis, patients with normal troponin at admission and MI injury on Day 2 had the highest mortality risk (hazard ratio 3.78, 95% confidence interval 1.10–13.09, P = 0.035). Conclusions In patients admitted for COVID‐19, re‐test MI on Day 2 provides a prognostic value. A non‐negligible proportion of patients with incident MI on Day 2 is identified at high risk of death only by the second measurement.

show abstract

Section: Limitationsmentioning

confidence: 87%

The prognostic value of serial troponin measurements in patients admitted for COVID‐19

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, 2.7% of our study population developed right heart failure, without having any clear previous risk factors, and not linked to the development of hypertension or left heart failure. This could be a consequence of either impaired right ventricular longitudinal strain (RVLS)-as proposed by Nuzzi et al after finding that 42% of patients who had recovered from COVID-19 without pulmonary hypertension had RVLS [52]-or the development of pulmonary hypertension. In fact, pulmonary hypertension was found in 12% of COVID-19 patients admitted to the ICU [53].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge

Maestre-Muñiz

Arias

Mata-Vázquez

et al. 2021

JCM

136

126

View full text Add to dashboard Cite

Background: The long-term effects of COVID-19 remain largely unclear. This study aims to investigate post-acute health consequences and mortality one year after hospital discharge. Methods: All surviving adult patients who were discharged after hospital admission due to acute COVID-19 in the first wave of the pandemic underwent a comprehensive interview. Functional assessment was performed in patients aged over 65. Clinical and hospital records were reviewed and mortality causes assessed. Results: A total of 587 patients with COVID-19 were discharged from hospital, including 266 after hospital admission and 321 from the emergency room. Mortality within the following year occurred in 34/266 (12.8%) and 10/321 (3.1%), respectively, due to causes directly or possibly related to COVID-19 in 20.5% and 25% of patients. Post-COVID-19 syndrome was assessed in 543 patients at one year from discharge. Any clinical complaint was reported by 90.1% of patients who needed hospitalization and 80.4% of those discharged from the emergency room (p = 0.002), with breathlessness (41.6%), tiredness (35.4%), ageusia (30.2%), and anosmia (26.3%) being the most common complaints. Ongoing symptoms attributed to COVID-19 were reported by 66.8% and 49.5% of patients, respectively (p < 0.001). Newly developed COPD, asthma, diabetes, heart failure, and arthritis—as well as worsening of preexisting comorbidities—were found. Conclusions: One-year mortality among survivors of acute COVID-19 was 7.5%. A significant proportion of COVID-19 patients experienced ongoing symptoms at 1 year from onset of the disease.

show abstract

“…It is therefore reasonable to hypothesise that despite the different public health approaches over time, the impact of the COVID-pandemic was consistent throughout the entire period. Furthermore, the presence of subclinical cardiac dysfunction, especially in recovered COVID patients [22] , [23] , might not be completely excluded and deserves further investigation.…”

Section: Discussionmentioning

confidence: 99%

Patients hospitalised with heart failure across different waves of the COVID-19 pandemic show consistent clinical characteristics and outcomes

Rind

Cannatà

McDonaugh

et al. 2022

International Journal of Cardiology

View full text Add to dashboard Cite

Background During the first wave of the COVID-19 pandemic, admissions for cardiovascular disease, including Heart Failure (HF), were reduced. Patients hospitalised for HF were sicker and with increased in-hospital mortality. So far, whether following waves had a different impact on HF patients is unknown. Methods All consecutive patients hospitalised for acute heart failure during three different COVID-19 related national lockdowns were analysed. The lockdown periods were defined according to Government guidelines as 23/3/2020 to 4/7/2020 (First Lockdown), 4/11/2020 to 2/12/2020 (Second Lockdown) and 5/1/2021 to 28/2/2021 (Third Lockdown). Results Overall, 184 patients hospitalised for HF were included in the study, 95 during the 1st lockdown, 30 during the 2nd lockdown and 59 during the 3rd lockdown. Across the three groups had comparable clinical characteristics, comorbidities and cardiovascular risk factors. Specialist in-hospital care was uninterrupted during the pandemic showing comparable mortality rates ( p = 0.10). Although medical therapy for HF was comparable between the three lockdowns, a significantly higher proportion of patients received Angiotensin Receptor-Neprilysin Inhibitors (ARNI) in the second and third lockdowns ( p < 0.001). Conclusions Although public health approaches changed throughout the pandemic, the clinical characteristics and outcomes of HF patients were consistent across different waves. For patients hospitalised in the subsequent waves, a more rapid optimization of medical therapy was observed during hospitalization. Particular attention should be devoted to prevent collateral cardiovascular damage during public health emergencies.

show abstract

Impaired Right Ventricular Longitudinal Strain Without Pulmonary Hypertension in Patients Who Have Recovered From COVID-19

Cited by 26 publications

References 5 publications

The prognostic value of serial troponin measurements in patients admitted for COVID‐19

The prognostic value of serial troponin measurements in patients admitted for COVID‐19

Long-Term Outcomes of Patients with Coronavirus Disease 2019 at One Year after Hospital Discharge

Patients hospitalised with heart failure across different waves of the COVID-19 pandemic show consistent clinical characteristics and outcomes

Contact Info

Product

Resources

About