Relationship between echocardiographic tricuspid annular plane systolic excursion and mortality in COVID‐19 patients: A Meta‐analysis

Zuin, Marco; Rigatelli, Gianluca; Roncon, Loris; Zuliani, Giovanni

doi:10.1111/echo.15175

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…Previous studies have demonstrated the clinical utility of cardiac and lung POCUS for triage, diagnosis, and management of patients with COVID‐19 13–14 . Other studies also showed high rates of cardiac and pulmonary abnormalities, as well as the ability to predict a worse outcome in this group of patients 1,2,15,16 . However, most of these studies were performed with full‐size standard ultrasound machines.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14] Other studies also showed high rates of cardiac and pulmonary abnormalities, as well as the ability to predict a worse outcome in this group of patients. 1,2,15,16 However, most of these studies were performed with full-size standard ultrasound machines.…”

Section: Discussionmentioning

confidence: 99%

“… 13 , 14 Other studies also showed high rates of cardiac and pulmonary abnormalities, as well as the ability to predict a worse outcome in this group of patients. 1 , 2 , 15 , 16 However, most of these studies were performed with full‐size standard ultrasound machines. When compared to standard ultrasound machines, hand‐held ultrasound devices might be more useful in patients with suspected or confirmed COVID‐19 infection, due to their improved mobility and smaller size which allow faster cleaning and decontamination resulting in shorter test time and reduced operator exposure and hence less risk.…”

Section: Discussionmentioning

confidence: 99%

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The quality, safety, feasibility, and interpretive accuracy of echocardiographic and lung ultrasound assessment of COVID‐19 patients using a hand‐held ultrasound

et al. 2022

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Background The association between COVID‐19 infection and the cardiovascular system necessitates the use of an echocardiogram in this setting. Information on the utilization, safety, and quality of point‐of‐care cardiac and lung ultrasound using a hand‐held device in these patients is scarce. Aims To investigate the safety, technical aspects, quality indices, and interpretive accuracy of a hand‐held echocardiogram in patients with COVID‐19. Methods From April‐28 through July‐27, 2020, consecutive patients with COVID‐19 underwent hand‐held echocardiogram and lung ultrasound evaluation (Vscan Extend™; GE Healthcare) within 48‐h of admission. The operators recorded a series of technical parameters and graded individual experiences. The examinations were further analyzed by a blinded fellowship‐trained echocardiographer for general quality, proper acquisition, and right ventricular (RV) demonstration. Results Among 103 patients, 66 (64.1%) were male. Twenty‐nine (28.2%) patients could not turn on their left side and 23 (22.3%) could not maintain effective communication. The mean length of each echocardiogram study was 8.5 ± 2.9 min, battery usage was 14 ± 5%, and mean operator‐to‐patient proximity was 59 ± 11 cm. Ninety‐five (92.2%) examinations were graded as fair/good quality. A fair agreement was demonstrated between the operator and the echocardiographer for general ultrasound quality (Kappa = 0.329, p < 0.001). A fair‐good correlation (r = 0.679, p < 0.001) and substantial agreement (Kappa = 0.612, p < 0.001) were demonstrated between the operator and echocardiographer for left ventricular ejection fraction (LVEF), whereas a fair agreement was demonstrated for RV systolic function (Kappa = 0.308, p = 0.002). LVEF agreement was also assessed using the Bland‐Altman analysis revealing a mean bias of −0.96 (95% limits of agreement 9.43 to −11.35; p = 0.075). Conclusions Among patients with COVID‐19, echocardiography with a hand‐held ultrasound is a safe and reasonable alternative for a complete formal study (<10% poor‐quality indices). Echocardiogram assessment by the operators during the exam acquisition is reliable for LVEF, while RV systolic function should be subsequently offline reassessed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The quality, safety, feasibility, and interpretive accuracy of echocardiographic and lung ultrasound assessment of COVID‐19 patients using a hand‐held ultrasound

et al. 2022

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“…A decreased TAPSE (<17 mm) was found in three (8.6%) moderate and five (35.7%) critically-severe patients [12]. The American Society of Echocardiography recommends routinely using (TAPSE) to evaluate the RV systolic function; a low TAPSE value may be considered an earlier manifestation of cardiac involvement or complications in COVID-19 patients [13].…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Assessment in Critically Ill COVID-19 Patients and its Prognostic Importance

Mohamad

Gawish²,

Abdrabo³

et al. 2022

Open Access Maced J Med Sci

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Background; Cardiac injury is a prevalent complication and is associated with worse prognosis in COVID-19 patients. The increased cardiac workload resulting from respiratory failure and hypoxemia is a common mechanism of cardiac injury and the right ventricle may bear the brunt of its impact. The aim of the present study was to determine the incidence and prognostic value of RV dysfunction in COVID-19 patients admitted to ICU using conventional echocardiography parameters.Patients were subjected to full history taking, and clinical examination, Computed Tomography of chest was done for all patients to assess severity of lung infiltration, all patients received standard treatment according to Ministry of Health and Population COVID19 treatment protocol recommendations. Echocardiographic assessment was done to all patients.The mean age of the patients was 61.10±9.64years (range 42-80years).There were 36 (60%) male and 24 (40%) female. The non-survivor group consisted of 28 patients (46.7%) and survivors consisted of 32 patients (53.3%). There was statistically significant association between mortality and RV function regarding TAPSE, FAC%, RV basal diameter and EPAP. We concluded that in COVID-19 patients, RV function must be assessed and its prognostic importance recognized. RV dysfunction is not only a symptom of high pulmonary pressures, but it also contributes to cardiac insufficiency.

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“…4,5 The adverse effect of COVID-19 on the RV is unsurprising as prior studies revealed RV dilation or dysfunction are the most common echocardiographic findings in those with acute respiratory distress syndrome (ARDS) 6,7 and RV dysfunction is associated with mortality in ARDS. 8 While substantial evidence suggests that RV dysfunction is associated with in-hospital mortality in acute COVID-19, [9][10][11] the prognostic implications of RV dilation alone are less clear. While some studies have found an association between RV dilation and mortality 12,13 , others have not.…”

Section: Introductionmentioning

confidence: 99%

Association of Right Ventricular Dilation and Dysfunction on Echocardiogram with In-Hospital Mortality Among Patients Hospitalized with COVID-19 Compared with Other Acute Respiratory Illness

Sun¹,

Cedarbaum

Hill

et al. 2022

Preprint

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Background: Although right ventricular (RV) dysfunction is associated with mortality in acute COVID-19, the role of RV dilation is uncertain. The prognostic significance of RV dilation and dysfunction among hospitalized patients with acute COVID-19 compared to other respiratory illnesses. Methods: We conducted a retrospective cohort study to examine 225 consecutive adults admitted for acute COVID-19 and 6,150 control adults admitted for influenza, pneumonia or ARDS who had a clinical echocardiogram performed. We used logistic regression models to assess associations between RV parameters and in-hospital mortality adjusted for confounders. Results: Among those with COVID-19, 48/225 (21.3%) died during the index hospitalization compared to 727/6150 (11.8%) with other respiratory illness (p=0.001). Independent of COVID-19, mild and moderate to severe RV dilation were associated with 1.4 and 2.0 times higher risk of inpatient mortality, respectively (95%CI 1.17 to 1.69; p=0.0003; 95%CI 1.62 to 2.47; p<0.0001, respectively). Similarly, mild and moderate RV dysfunction were associated with 1.4 and 1.7 times higher risk of inpatient mortality (95%CI 1.10 to 1.77; p=0.007; 95%CI 1.17 to 2.42; p=0.005, respectively). Relative to normal RV size and non-COVID-19 acute respiratory illness, mild and moderate RV dilation were associated with 1.4 times and 2.0 times higher risk among those without COVID-19 and 1.9 times higher and 3.0 times higher risk among those with COVID-19, with similar findings for RV dysfunction. Having both RV dilation and dysfunction or RV dilation alone were associated with 1.7 times higher risk while RV dysfunction alone was associated with 1.4 times higher risk compared to normal RV size and function. Conclusions: RV dilation and dysfunction are associated with increased risk of inpatient mortality among those with COVID-19 and other respiratory illnesses. Abnormal RV findings may identify those at higher risk of short-term mortality from acute respiratory illness including COVID-19 beyond other risk markers.

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Relationship between echocardiographic tricuspid annular plane systolic excursion and mortality in COVID‐19 patients: A Meta‐analysis

Cited by 5 publications

References 37 publications

The quality, safety, feasibility, and interpretive accuracy of echocardiographic and lung ultrasound assessment of COVID‐19 patients using a hand‐held ultrasound

The quality, safety, feasibility, and interpretive accuracy of echocardiographic and lung ultrasound assessment of COVID‐19 patients using a hand‐held ultrasound

Right Ventricular Assessment in Critically Ill COVID-19 Patients and its Prognostic Importance

Association of Right Ventricular Dilation and Dysfunction on Echocardiogram with In-Hospital Mortality Among Patients Hospitalized with COVID-19 Compared with Other Acute Respiratory Illness

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