Integrated clinical role of echocardiography in patients with COVID-19

Pagnesi, Matteo; Baldetti, Luca; Beneduce, Alessandro; Calvo, Francesco; Gramegna, Mario; Pazzanese, Vittorio; Ingallina, Giacomo; Napolano, Antonio; Finazzi, Renato; Ruggeri, Annalisa; Ajello, Silvia; Melisurgo, Giulio; Camici, Paolo G.; Scarpellini, Paolo; Tresoldi, Moreno; Landoni, Giovanni; Ciceri, Fabio; Scandroglio, Anna Mara; Agricola, Eustachio; Cappelletti, Alberto

doi:10.1136/heartjnl-2020-318310

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…In both non-ICU patients 84 and ICU patients, 85 an sPAP > 35 mmHg is a parameter predictive of mortality in COVID-19. Finally, an RVLS with a cut-off of −20% to −21% calculated by two-dimensional speckle tracking echocardiography seems to be able to detect abnormal RV function.…”

Section: Echocardiographymentioning

confidence: 99%

Coronavirus disease 2019-induced hypercoagulability and its clinical implications

Jaramillo

2021

Asian Cardiovasc Thorac Ann

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Coronavirus disease 2019 is the disease produced by severe acute respiratory syndrome-coronavirus-2, which is introduced into the host’s cell thanks to the angiotensin-converting enzyme 2 receptor. Once there, it uses the cell’s machinery to multiply itself. In this process, it generates an immune response that stimulates the lymphocytes to produce cytokines and reactive oxygen species that begin to deteriorate the endothelial cell. Complement activation, through the complement attack complex and C5a, contributes to this endothelial damage. The different mediators further promote the expression of adhesion molecules on the endothelial surface, which encourages all blood cells to adhere to the endothelial surface to form small conglomerates, called clots, which obstruct the lumen of the small blood vessels. Furthermore, the mediators of clot lysis are inhibited. All this promotes a prothrombotic environment within the pulmonary capillaries that is reflected in the elevation of D-dimer. The only solution for this cascade of events seems to be the implementation of an effective anticoagulation protocol that early counteracts the changes induced by thrombi in the pulmonary circulation and reflected in the functioning of the right ventricle.

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Section: Echocardiographymentioning

confidence: 99%

Coronavirus disease 2019-induced hypercoagulability and its clinical implications

Jaramillo

2021

Asian Cardiovasc Thorac Ann

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“…Studi oleh Kim et al 18 dan Pagnesi et al 23 membagi penilaian parameter ekokardiografi fungsi ventrikel kanan ke dalam dua grup, yaitu pasien dengan dan tanpa disfungsi ventrikel kanan. Dari studi ini ditemukan perbedaan pada rerata nilai TAPSE dan RV S' pada kedua grup, dimana rerata nilai TAPSE dan RV S' secara bermakna lebih rendah pada grup dengan disfungsi ventrikel kanan dibandingkan dengan grup tanpa disfungsi ventrikel kanan.…”

Section: Bahasanunclassified

Right Ventricle Dysfunction in COVID-19 Patients

Labi

Panda

Jim³

2022

eCL

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Coronavirus disease 2019 (COVID-19) has become a global pandemic. Related to its pathomechanisms and complications, COVID-19 is identified as a complex multi-organ disease. Cardiac involvement is reported in COVID-19 patients. One of the cardiovascular complications of COVID-19 is right ventricular dysfunction. This study aimed to provide an overview of right ventricular dysfunction in COVID-19 patients and its association with the patient's clinical outcomes. This was a literature review study conducted by searching and reviewing literatures on online databases as follows: PubMed, ScienceDirect, and ProQuest. There were 14 literatures obtained in this study with a total of 1,435 patients. All articles were observational studies conducted in January-April 2020 across various countries. Samples of patients with right ventricular dysfunction ranged from 3.6 to 41.7% of the total population of each study. Most studies defined right ventricle dysfunction as TAPSE<16-17 mm. Several echocardiography parameters and their threshold values were as follows: RV S' <9,5-10 cm/s; RVFAC <35%; right ventricular free wall strain (RVFWS); and right ventricular global longitudinal strain (RVGLS) according to ASE guidelines. In conclusion, right ventricular dysfunction has a high prevalence and is associated with poor outcomes of COVID-19 patients. Transthoracic echocardiography examination might become a risk stratification modality in hospitalized COVID-19 patients.Keywords: right ventricular dysfunction; coronavirus disease 2019; transthoracic echocardiography Abstrak: Coronavirus disease 2019 (COVID-19) telah menjadi pandemi global. Terkait dengan patomekanisme dan komplikasinya, COVID-19 dinyatakan sebagai penyakit multi-organ kompleks. Telah dilaporkan adanya keterlibatan jantung pada COVID-19. Salah satu komplikasi kardiovaskular dari COVID-19 ialah disfungsi ventrikel kanan. Penelitian ini bertujuan untuk memberikan gambaran disfungsi ventrikel kanan pada pasien COVID-19 dan hubungannya terhadap luaran klinis pasien. Jenis penelitian ialah literature review. Melalui penelusuran pada tiga database (PubMed, ScienceDirect, ProQuest), didapatkan 14 literatur dengan total 1.435 pasien. Semua artikel merupakan studi observasional yang dilakukan pada Januari-April 2020 dan tersebar di berbagai negara. Sampel pasien dengan disfungsi ventrikel kanan tercatat berkisar antara 3,6-41,7% dari total populasi tiap studi. Sebagian besar studi menetapkan definisi disfungsi ventrikel kanan dengan nilai TAPSE<16-17 mm. Beberapa parameter ekokardiografi lain beserta nilai ambang yang digunakan yaitu: RV S' <9,5-10 cm/s; RVFAC <35%; serta right ventricular free wall strain (RVFWS) dan right ventricular global longitudinal strain (RVGLS) berdasarkan panduan ASE. Simpulan penelitian ini ialah disfungsi ventrikel kanan pada COVID-19 memiliki prevalensi tinggi dan berhubungan dengan luaran pasien yang buruk. Pemeriksaan ekokardiografi transtorakal dapat menjadi modalitas stratifikasi risiko pada pasien COVID-19 yang dirawat inap.Kata kunci: disfungsi ventrikel kanan; coronavirus disease 2019; ekokardiografi transtorakal

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“…The results are dependent on the disease severity of the sample. For example, in a population with a median ratio of arterial oxygen partial pressure to fractional inspired oxygen (Pa O2 /Fi O2 ) of 243, RV dysfunction (based on TAPSE and S′) was not associated with Pa O2 /Fi O2 and had no predictive power for mortality [53]. Conversely, RV dysfunction (based on TAPSE and RVFAC) was associated with Pa O2 /Fi O2 and all-cause mortality in samples with higher rate of IMV patients (mean Pa O2 /Fi O2 of 144) [50].…”

Section: Right Ventricular Systolic Dysfunctionmentioning

confidence: 99%

“…Moreover, a direct correlation has been found between sPAP, D-dimer and troponin [38]. A study stratifying non-intensive care unit (ICU) patients according to presence/absence of PH (defined as sPAP > 35 mmHg) [53] showed that, after adjustments for confounders, PH was the only significative predictive parameter of mortality. According to the authors, the initial hemodynamic alterations caused by SARS-CoV-2 pneumonia may determine only modest sPAP elevation, still not sufficient to induce significant RV dysfunction.…”

Section: Pulmonary Hypertensionmentioning

confidence: 99%

Echocardiographic assessment of the right ventricle in COVID-19: a systematic review

Ghidini

Gasperetti

Winterton

et al. 2021

Int J Cardiovasc Imaging

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Cardiac involvement has been frequently reported in COVID-19 as responsible of increased morbidity and mortality. Given the importance of right heart function in acute and chronic respiratory diseases, its assessment in SARS-CoV-2 infected patients may add prognostic accuracy. Transthoracic echocardiography has been proposed to early predict myocardial injury and risk of death in hospitalized patients. This systematic review presents the up-to-date sum of literature regarding right ventricle ultrasound assessment. We evaluated commonly used echocardiographic parameters to assess RV function and discussed their relationship with pathophysiological mechanisms involved in COVID-19. We searched Medline and Embase for studies that used transthoracic echocardiography for right ventricle assessment in patients with COVID-19.

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Integrated clinical role of echocardiography in patients with COVID-19

Cited by 7 publications

References 8 publications

Coronavirus disease 2019-induced hypercoagulability and its clinical implications

Coronavirus disease 2019-induced hypercoagulability and its clinical implications

Right Ventricle Dysfunction in COVID-19 Patients

Echocardiographic assessment of the right ventricle in COVID-19: a systematic review

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