tetano
Editor, Senior Moderator
Hypertension
. 2021 May 10;HYPERTENSIONAHA12117099.
doi: 10.1161/HYPERTENSIONAHA.121.17099. Online ahead of print.
First-Phase Ejection Fraction, a Measure of Preclinical Heart Failure, Is Strongly Associated With Increased Mortality in Patients With COVID-19
Haotian Gu[SUP] #[/SUP][SUP] 1 [/SUP], Chiara Cirillo[SUP] #[/SUP][SUP] 2 [/SUP], Adam A Nabeebaccus[SUP] #[/SUP][SUP] 1 3 [/SUP], Zhenxing Sun[SUP] #[/SUP][SUP] 4 5 [/SUP], Lingyun Fang[SUP] #[/SUP][SUP] 4 5 [/SUP], Yuji Xie[SUP] #[/SUP][SUP] 4 5 [/SUP], Ozan Demir[SUP] 1 2 [/SUP], Nishita Desai[SUP] 2 [/SUP], Lin He[SUP] 4 5 [/SUP], Qing L?[SUP] 4 5 [/SUP], Eleni Nakou[SUP] 3 [/SUP], Kevin O'Gallagher[SUP] 1 3 [/SUP], Christos Tountas[SUP] 3 [/SUP], Apostolia Marvaki[SUP] 3 [/SUP], Mark Monaghan[SUP] 1 3 [/SUP], Divaka Perera[SUP] 1 2 [/SUP], Ana Pericao[SUP] 2 [/SUP], Matthew Ryan[SUP] 1 2 [/SUP], Hannah Sinclair[SUP] 2 [/SUP], Vasileios Stylianidis[SUP] 2 [/SUP], Kelly Victor[SUP] 2 [/SUP], Bin Wang[SUP] 4 5 [/SUP], Jing Wang[SUP] 4 5 [/SUP], Rui Wang[SUP] 4 5 [/SUP], Chun Wu[SUP] 4 5 [/SUP], Yali Yang[SUP] 4 5 [/SUP], Hongliang Yuan[SUP] 4 5 [/SUP], Danqing Zhang[SUP] 4 5 [/SUP], Yongxing Zhang[SUP] 4 5 [/SUP], Luca Faconti[SUP] 1 2 [/SUP], Alexandros Papachristidis[SUP] 1 3 [/SUP], Li Zhang[SUP] #[/SUP][SUP] 4 5 [/SUP], Gerald Carr-White[SUP] #[/SUP][SUP] 1 2 [/SUP], Ajay M Shah[SUP] #[/SUP][SUP] 1 3 [/SUP], Mingxing Xie[SUP] #[/SUP][SUP] 4 5 [/SUP], Phil Chowienczyk[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
Abstract
Presence of heart failure is associated with a poor prognosis in patients with coronavirus disease 2019 (COVID-19). The aim of the present study was to examine whether first-phase ejection fraction (EF1), the ejection fraction measured in early systole up to the time of peak aortic velocity, a sensitive measure of preclinical heart failure, is associated with survival in patients hospitalized with COVID-19. A retrospective outcome study was performed in patients hospitalized with COVID-19 who underwent echocardiography (n=380) at the West Branch of the Union Hospital, Wuhan, China and in patients admitted to King's Health Partners in South London, United Kingdom. Association of EF1 with survival was performed using Cox proportional hazards regression. EF1 was compared in patients with COVID-19 and in historical controls with similar comorbidities (n=266) who had undergone echocardiography before the COVID-19 pandemic. In patients with COVID-19, EF1 was a strong predictor of survival in each patient group (Wuhan and London). In the combined group, EF1 was a stronger predictor of survival than other clinical, laboratory, and echocardiographic characteristics including age, comorbidities, and biochemical markers. A cutoff value of 25% for EF1 gave a hazard ratio of 5.23 ([95% CI, 2.85-9.60]; P<0.001) unadjusted and 4.83 ([95% CI, 2.35-9.95], P<0.001) when adjusted for demographics, comorbidities, hs-cTnI (high-sensitive cardiac troponin), and CRP (C-reactive protein). EF1 was similar in patients with and without COVID-19 (23.2?7.3 versus 22.0?7.6%, P=0.092, adjusted for prevalence of risk factors and comorbidities). Impaired EF1 is strongly associated with mortality in COVID-19 and probably reflects preexisting, preclinical heart failure.
Keywords: COVID-19; ejection fraction; heart failure; prevalence; prognosis; risk factor; systole.
. 2021 May 10;HYPERTENSIONAHA12117099.
doi: 10.1161/HYPERTENSIONAHA.121.17099. Online ahead of print.
First-Phase Ejection Fraction, a Measure of Preclinical Heart Failure, Is Strongly Associated With Increased Mortality in Patients With COVID-19
Haotian Gu[SUP] #[/SUP][SUP] 1 [/SUP], Chiara Cirillo[SUP] #[/SUP][SUP] 2 [/SUP], Adam A Nabeebaccus[SUP] #[/SUP][SUP] 1 3 [/SUP], Zhenxing Sun[SUP] #[/SUP][SUP] 4 5 [/SUP], Lingyun Fang[SUP] #[/SUP][SUP] 4 5 [/SUP], Yuji Xie[SUP] #[/SUP][SUP] 4 5 [/SUP], Ozan Demir[SUP] 1 2 [/SUP], Nishita Desai[SUP] 2 [/SUP], Lin He[SUP] 4 5 [/SUP], Qing L?[SUP] 4 5 [/SUP], Eleni Nakou[SUP] 3 [/SUP], Kevin O'Gallagher[SUP] 1 3 [/SUP], Christos Tountas[SUP] 3 [/SUP], Apostolia Marvaki[SUP] 3 [/SUP], Mark Monaghan[SUP] 1 3 [/SUP], Divaka Perera[SUP] 1 2 [/SUP], Ana Pericao[SUP] 2 [/SUP], Matthew Ryan[SUP] 1 2 [/SUP], Hannah Sinclair[SUP] 2 [/SUP], Vasileios Stylianidis[SUP] 2 [/SUP], Kelly Victor[SUP] 2 [/SUP], Bin Wang[SUP] 4 5 [/SUP], Jing Wang[SUP] 4 5 [/SUP], Rui Wang[SUP] 4 5 [/SUP], Chun Wu[SUP] 4 5 [/SUP], Yali Yang[SUP] 4 5 [/SUP], Hongliang Yuan[SUP] 4 5 [/SUP], Danqing Zhang[SUP] 4 5 [/SUP], Yongxing Zhang[SUP] 4 5 [/SUP], Luca Faconti[SUP] 1 2 [/SUP], Alexandros Papachristidis[SUP] 1 3 [/SUP], Li Zhang[SUP] #[/SUP][SUP] 4 5 [/SUP], Gerald Carr-White[SUP] #[/SUP][SUP] 1 2 [/SUP], Ajay M Shah[SUP] #[/SUP][SUP] 1 3 [/SUP], Mingxing Xie[SUP] #[/SUP][SUP] 4 5 [/SUP], Phil Chowienczyk[SUP] #[/SUP][SUP] 1 [/SUP]
Affiliations
- PMID: 33966447
- DOI: 10.1161/HYPERTENSIONAHA.121.17099
Abstract
Presence of heart failure is associated with a poor prognosis in patients with coronavirus disease 2019 (COVID-19). The aim of the present study was to examine whether first-phase ejection fraction (EF1), the ejection fraction measured in early systole up to the time of peak aortic velocity, a sensitive measure of preclinical heart failure, is associated with survival in patients hospitalized with COVID-19. A retrospective outcome study was performed in patients hospitalized with COVID-19 who underwent echocardiography (n=380) at the West Branch of the Union Hospital, Wuhan, China and in patients admitted to King's Health Partners in South London, United Kingdom. Association of EF1 with survival was performed using Cox proportional hazards regression. EF1 was compared in patients with COVID-19 and in historical controls with similar comorbidities (n=266) who had undergone echocardiography before the COVID-19 pandemic. In patients with COVID-19, EF1 was a strong predictor of survival in each patient group (Wuhan and London). In the combined group, EF1 was a stronger predictor of survival than other clinical, laboratory, and echocardiographic characteristics including age, comorbidities, and biochemical markers. A cutoff value of 25% for EF1 gave a hazard ratio of 5.23 ([95% CI, 2.85-9.60]; P<0.001) unadjusted and 4.83 ([95% CI, 2.35-9.95], P<0.001) when adjusted for demographics, comorbidities, hs-cTnI (high-sensitive cardiac troponin), and CRP (C-reactive protein). EF1 was similar in patients with and without COVID-19 (23.2?7.3 versus 22.0?7.6%, P=0.092, adjusted for prevalence of risk factors and comorbidities). Impaired EF1 is strongly associated with mortality in COVID-19 and probably reflects preexisting, preclinical heart failure.
Keywords: COVID-19; ejection fraction; heart failure; prevalence; prognosis; risk factor; systole.