tetano
Editor, Senior Moderator
J Pers Med
. 2021 Nov 24;11(12):1245.
doi: 10.3390/jpm11121245.
Prognostic Implications of Right Ventricular Function and Pulmonary Pressures Assessed by Echocardiography in Hospitalized Patients with COVID-19
Maria Vincenza Polito[SUP] 1 [/SUP], Angelo Silverio[SUP] 2 [/SUP], Marco Di Maio[SUP] 2 [/SUP], Michele Bellino[SUP] 2 [/SUP], Fernando Scudiero[SUP] 3 [/SUP], Vincenzo Russo[SUP] 4 [/SUP], Barbara Rasile[SUP] 2 [/SUP], Carmine Alfano[SUP] 2 [/SUP], Rodolfo Citro[SUP] 1 [/SUP], Guido Parodi[SUP] 5 [/SUP], Carmine Vecchione[SUP] 2 [/SUP], Gennaro Galasso[SUP] 2 [/SUP]
Affiliations
Abstract
Aims: Pulmonary involvement in Coronavirus disease 2019 (COVID-19) may affect right ventricular (RV) function and pulmonary pressures. The prognostic value of tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (PAPS), and TAPSE/PAPS ratios have been poorly investigated in this clinical setting.
Methods and results: This is a multicenter Italian study, including consecutive patients hospitalized for COVID-19. In-hospital mortality and pulmonary embolism (PE) were identified as the primary and secondary outcome measures, respectively. The study included 227 (16.1%) subjects (mean age 68 ± 13 years); intensive care unit (ICU) admission was reported in 32.2%. At competing risk analysis, after stratifying the population into tertiles, according to TAPSE, PAPS, and TAPSE/PAPS ratio values, patients in the lower TAPSE and TAPSE/PAPS tertiles, as well as those in the higher PAPS tertiles, showed a significantly higher incidence of death vs. the probability to be discharged during the hospitalization. At univariable logistic regression analysis, TAPSE, PAPS, and TAPSE/PAPS were significantly associated with a higher risk of death and PE, both in patients who were and were not admitted to ICU. At adjusted multivariable regression analysis, TAPSE, PAPS, and TAPSE/PAPS resulted in independently associated risk of in-hospital death (TAPSE: OR 0.85, CI 0.74-0.97; PAPS: OR 1.08, CI 1.03-1.13; TAPSE/PAPS: OR 0.02, CI 0.02 × 10[SUP]-1[/SUP]-0.2) and PE (TAPSE: OR 0.7, CI 0.6-0.82; PAPS: OR 1.1, CI 1.05-1.14; TAPSE/PAPS: OR 0.02 × 10[SUP]-1[/SUP], CI 0.01 × 10[SUP]-2[/SUP]-0.04).
Conclusions: Echocardiographic evidence of RV systolic dysfunction, increased PAPS, and poor RV-arterial coupling may help to identify COVID-19 patients at higher risk of mortality and PE during hospitalization.
Keywords: COVID-19; RV–arterial coupling; TAPSE; coronavirus; outcome; pulmonary hypertension; right ventricular dysfunction.
. 2021 Nov 24;11(12):1245.
doi: 10.3390/jpm11121245.
Prognostic Implications of Right Ventricular Function and Pulmonary Pressures Assessed by Echocardiography in Hospitalized Patients with COVID-19
Maria Vincenza Polito[SUP] 1 [/SUP], Angelo Silverio[SUP] 2 [/SUP], Marco Di Maio[SUP] 2 [/SUP], Michele Bellino[SUP] 2 [/SUP], Fernando Scudiero[SUP] 3 [/SUP], Vincenzo Russo[SUP] 4 [/SUP], Barbara Rasile[SUP] 2 [/SUP], Carmine Alfano[SUP] 2 [/SUP], Rodolfo Citro[SUP] 1 [/SUP], Guido Parodi[SUP] 5 [/SUP], Carmine Vecchione[SUP] 2 [/SUP], Gennaro Galasso[SUP] 2 [/SUP]
Affiliations
- PMID: 34945717
- DOI: 10.3390/jpm11121245
Abstract
Aims: Pulmonary involvement in Coronavirus disease 2019 (COVID-19) may affect right ventricular (RV) function and pulmonary pressures. The prognostic value of tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (PAPS), and TAPSE/PAPS ratios have been poorly investigated in this clinical setting.
Methods and results: This is a multicenter Italian study, including consecutive patients hospitalized for COVID-19. In-hospital mortality and pulmonary embolism (PE) were identified as the primary and secondary outcome measures, respectively. The study included 227 (16.1%) subjects (mean age 68 ± 13 years); intensive care unit (ICU) admission was reported in 32.2%. At competing risk analysis, after stratifying the population into tertiles, according to TAPSE, PAPS, and TAPSE/PAPS ratio values, patients in the lower TAPSE and TAPSE/PAPS tertiles, as well as those in the higher PAPS tertiles, showed a significantly higher incidence of death vs. the probability to be discharged during the hospitalization. At univariable logistic regression analysis, TAPSE, PAPS, and TAPSE/PAPS were significantly associated with a higher risk of death and PE, both in patients who were and were not admitted to ICU. At adjusted multivariable regression analysis, TAPSE, PAPS, and TAPSE/PAPS resulted in independently associated risk of in-hospital death (TAPSE: OR 0.85, CI 0.74-0.97; PAPS: OR 1.08, CI 1.03-1.13; TAPSE/PAPS: OR 0.02, CI 0.02 × 10[SUP]-1[/SUP]-0.2) and PE (TAPSE: OR 0.7, CI 0.6-0.82; PAPS: OR 1.1, CI 1.05-1.14; TAPSE/PAPS: OR 0.02 × 10[SUP]-1[/SUP], CI 0.01 × 10[SUP]-2[/SUP]-0.04).
Conclusions: Echocardiographic evidence of RV systolic dysfunction, increased PAPS, and poor RV-arterial coupling may help to identify COVID-19 patients at higher risk of mortality and PE during hospitalization.
Keywords: COVID-19; RV–arterial coupling; TAPSE; coronavirus; outcome; pulmonary hypertension; right ventricular dysfunction.