ABSTRACT
Background and Aim: A new infectious outbreak sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now spreading all around the world. The aim of this study was to evaluate the prognostic value of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) in patients with coronavirus disease 2019 (COVID-19). Methods: In this prospective, single-center study, data were gathered from patients treated for COVID-19 between April 15 and April 30, 2020. Two-dimensional echocardiography (2-DE) and speckle tracking echocardiography (STE) images were obtained for all patients. Patients were divided into three groups: those with severe COVID-19 infection, those with non-severe COVID-19 infection, and those without COVID-19 infection (the control group). Data regarding clinical characteristics and laboratory findings were obtained from electronic medical records. The primary endpoint was in-hospital mortality. Results: A total of 100 patients hospitalized for COVID-19 were included in this study. The mean age of the severe group (n=44) was 59.1±12.9, 40% of whom were male. The mean age of the non-severe group (n=56) was 53.7±15.1, 58% of whom were male. Of these patients, 22 died in the hospital. In patients in the severe group, LV-GLS and RV-LS were decreased compared to patients in the non-severe and control groups (LVGLS: -14.5±1.8 vs. -16.7±1.3 vs. -19.4±1.6, respectively [p<0.001];RV-LS: -17.2±2.3 vs. -20.5±3.2 vs. -27.3±3.1, respectively [p<0.001]). The presence of cardiac injury, D-dimer, arterial oxygen saturation (SaO2), LV-GLS (OR:1.63, 95% confidence interval [CI] 1.08-2.47;p=0.010) and RV-LS (OR:1.55, 95% CI 1.07-2.25;p=0.019) were identified as independent predictors of mortality via multivariate analysis. Conclusions: LV-GLS and RV-LS are independent predictors of in-hospital mortality in patients with COVID-19.
ABSTRACT
Background and Aim: In December 2019, a new coronavirus (SARS-CoV-2) is life-threatening in all countries of the world and causing serious morbidity and mortality. The aim of this study to delineate the prognostic value of right ventricular strain pattern on ECG in patients with COVID-19. Methods: Hospitalized patients with COVID-19 without a cardiac history were included consecutively in the study from 1 May to 31 May, 2020. ECG was performed on hospital admission and was evaluated as blind. ECG evidence of RV strain pattern was defined as (1) presence of SIQ3T3;(2) presence of complete or incomplete RBBB;(3) T-wave inversions in the precordial leads (V1-V3). The main outcome measure was death during hospitalization. Right ventricular echocardiographic and electrocardiographic parameters were compared. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. Results: Hospitalized 107 patients with COVID-19 were included in this study. The patients were divided two main groups as non-survivor and survivor. The mean age of the patients with non-survivor group was 59.0±18.6, while the mean age of the patients survivor group was 50.2±10.7. ST depression (38% vs 13%) and RV strain pattern (45% vs 9%) were higher in patients with non-survivor group. Multivariate analyses revealed that ARDS (OR:22.25, 95%CI:6.54-74.84;p<0.001), presence of cardiac injury (OR:6.95, 95%CI:1.45-33.27;p=0.015), RV strain pattern (OR:14.41, 95%CI:2.84-73.07;p=0.001) and ST depression (OR:6.06, 95%CI:1.23-29.72;p=0.026) are independent predictors of mortality. Conclusions: Right Ventricular Strain Pattern on ECG is an independent predictor of mortality in patients with COVID-19.