tetano
Editor, Senior Moderator
J Am Soc Echocardiogr
. 2020 Jun 17;S0894-7317(20)30376-X.
doi: 10.1016/j.echo.2020.06.009. Online ahead of print.
Indications for and Findings on Transthoracic Echocardiography in COVID-19
Sneha S Jain[SUP] 1 [/SUP], Qi Liu[SUP] 1 [/SUP], Jayant Raikhelkar[SUP] 1 [/SUP], Justin Fried[SUP] 1 [/SUP], Pierre Elias[SUP] 1 [/SUP], Timothy J Poterucha[SUP] 1 [/SUP], Ersilia M DeFilippis[SUP] 1 [/SUP], Hannah Rosenblum[SUP] 1 [/SUP], Elizabeth Y Wang[SUP] 1 [/SUP], Bjorn Redfors[SUP] 1 [/SUP], Kevin Clerkin[SUP] 1 [/SUP], Jan M Griffin[SUP] 1 [/SUP], Elaine Y Wan[SUP] 1 [/SUP], Marwah Abdalla[SUP] 1 [/SUP], Natalie A Bello[SUP] 1 [/SUP], Rebecca T Hahn[SUP] 1 [/SUP], Daichi Shimbo[SUP] 1 [/SUP], Shepard D Weiner[SUP] 1 [/SUP], Ajay J Kirtane[SUP] 1 [/SUP], Susheel K Kodali[SUP] 1 [/SUP], Daniel Burkhoff[SUP] 1 [/SUP], LeRoy E Rabbani[SUP] 1 [/SUP], Allan Schwartz[SUP] 1 [/SUP], Martin B Leon[SUP] 1 [/SUP], Shunichi Homma[SUP] 1 [/SUP], Marco R Di Tullio[SUP] 1 [/SUP], Gabriel Sayer[SUP] 1 [/SUP], Nir Uriel[SUP] 2 [/SUP], D Edmund Anstey[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Despite growing evidence of cardiovascular complications associated with coronavirus disease 2019 (COVID-19), there are few data regarding the performance of transthoracic echocardiography (TTE) and the spectrum of echocardiographic findings in this disease.
Methods: A retrospective analysis was performed among adult patients admitted to a quaternary care center in New York City between March 1 and April 3, 2020. Patients were included if they underwent TTE during the hospitalization after a known positive diagnosis for COVID-19. Demographic and clinical data were obtained using chart abstraction from the electronic medical record.
Results: Of 749 patients, 72 (9.6%) underwent TTE following positive results on severe acute respiratory syndrome coronavirus-2 polymerase chain reaction testing. The most common clinical indications for TTE were concern for a major acute cardiovascular event (45.8%) and hemodynamic instability (29.2%). Although most patients had preserved biventricular function, 34.7% were found to have left ventricular ejection fractions ≤ 50%, and 13.9% had at least moderately reduced right ventricular function. Four patients had wall motion abnormalities suggestive of stress-induced cardiomyopathy. Using Spearman rank correlation, there was an inverse relationship between high-sensitivity troponin T and left ventricular ejection fraction (ρ = -0.34, P = .006). Among 20 patients with prior echocardiograms, only two (10%) had new reductions in LVEF of >10%. Clinical management was changed in eight individuals (24.2%) in whom TTE was ordered for concern for acute major cardiovascular events and three (14.3%) in whom TTE was ordered for hemodynamic evaluation.
Conclusions: This study describes the clinical indications for use and diagnostic performance of TTE, as well as findings seen on TTE, in hospitalized patients with COVID-19. In appropriately selected patients, TTE can be an invaluable tool for guiding COVID-19 clinical management.
Keywords: COVID-19; Echocardiography.
. 2020 Jun 17;S0894-7317(20)30376-X.
doi: 10.1016/j.echo.2020.06.009. Online ahead of print.
Indications for and Findings on Transthoracic Echocardiography in COVID-19
Sneha S Jain[SUP] 1 [/SUP], Qi Liu[SUP] 1 [/SUP], Jayant Raikhelkar[SUP] 1 [/SUP], Justin Fried[SUP] 1 [/SUP], Pierre Elias[SUP] 1 [/SUP], Timothy J Poterucha[SUP] 1 [/SUP], Ersilia M DeFilippis[SUP] 1 [/SUP], Hannah Rosenblum[SUP] 1 [/SUP], Elizabeth Y Wang[SUP] 1 [/SUP], Bjorn Redfors[SUP] 1 [/SUP], Kevin Clerkin[SUP] 1 [/SUP], Jan M Griffin[SUP] 1 [/SUP], Elaine Y Wan[SUP] 1 [/SUP], Marwah Abdalla[SUP] 1 [/SUP], Natalie A Bello[SUP] 1 [/SUP], Rebecca T Hahn[SUP] 1 [/SUP], Daichi Shimbo[SUP] 1 [/SUP], Shepard D Weiner[SUP] 1 [/SUP], Ajay J Kirtane[SUP] 1 [/SUP], Susheel K Kodali[SUP] 1 [/SUP], Daniel Burkhoff[SUP] 1 [/SUP], LeRoy E Rabbani[SUP] 1 [/SUP], Allan Schwartz[SUP] 1 [/SUP], Martin B Leon[SUP] 1 [/SUP], Shunichi Homma[SUP] 1 [/SUP], Marco R Di Tullio[SUP] 1 [/SUP], Gabriel Sayer[SUP] 1 [/SUP], Nir Uriel[SUP] 2 [/SUP], D Edmund Anstey[SUP] 1 [/SUP]
Affiliations
- PMID: 32782131
- DOI: 10.1016/j.echo.2020.06.009
Abstract
Background: Despite growing evidence of cardiovascular complications associated with coronavirus disease 2019 (COVID-19), there are few data regarding the performance of transthoracic echocardiography (TTE) and the spectrum of echocardiographic findings in this disease.
Methods: A retrospective analysis was performed among adult patients admitted to a quaternary care center in New York City between March 1 and April 3, 2020. Patients were included if they underwent TTE during the hospitalization after a known positive diagnosis for COVID-19. Demographic and clinical data were obtained using chart abstraction from the electronic medical record.
Results: Of 749 patients, 72 (9.6%) underwent TTE following positive results on severe acute respiratory syndrome coronavirus-2 polymerase chain reaction testing. The most common clinical indications for TTE were concern for a major acute cardiovascular event (45.8%) and hemodynamic instability (29.2%). Although most patients had preserved biventricular function, 34.7% were found to have left ventricular ejection fractions ≤ 50%, and 13.9% had at least moderately reduced right ventricular function. Four patients had wall motion abnormalities suggestive of stress-induced cardiomyopathy. Using Spearman rank correlation, there was an inverse relationship between high-sensitivity troponin T and left ventricular ejection fraction (ρ = -0.34, P = .006). Among 20 patients with prior echocardiograms, only two (10%) had new reductions in LVEF of >10%. Clinical management was changed in eight individuals (24.2%) in whom TTE was ordered for concern for acute major cardiovascular events and three (14.3%) in whom TTE was ordered for hemodynamic evaluation.
Conclusions: This study describes the clinical indications for use and diagnostic performance of TTE, as well as findings seen on TTE, in hospitalized patients with COVID-19. In appropriately selected patients, TTE can be an invaluable tool for guiding COVID-19 clinical management.
Keywords: COVID-19; Echocardiography.