Hidden systolic dysfunction of the right ventricle in patients with increased pulmonary vascular resistance 3 months after COVID-19 pneumonia.
Kardiologiia
; 62(3): 16-20, 2022 Mar 31.
Article
in English, English
| MEDLINE | ID: covidwho-1789752
ABSTRACT
Aim To study the relationship of echocardiographic right ventricular (RV) structural and functional parameters and indexes of pulmonary vascular resistance (PVR) in patients 3 months after COVID-19 pneumonia.Material and methods This cross-sectional, observational study included 96 patients aged 46.7±15.2 years. The inclusion criteria were documented diagnosis of COVID-19-associated pneumonia and patient's willing to participate in the observation. Patients were examined upon hospitalization and during the control visit (at 3 months after discharge from the hospital). Images and video loops were processed, including the assessment of myocardial longitudinal strain (LS) by speckle tracking, according to the effective guidelines. The equation [tricuspid regurgitation velocity/ time-velocity integral of the RV outflow tract × 10 + 0.16] was used to determine PRV. Patients were divided into group 1 (n=31) with increased PRV ≥1.5 Wood units and group 2 (n=65) with PRV <1.5 Wood units.Results At baseline, groups did not differ in main clinical functional characteristics, including severity of lung damage by computed tomography (32.7±22.1 and 36.5±20.4â%, respectively. Ñ=0.418). Echocardiographic linear, planimetric and volumetric parameters did not significantly differ between the groups. In group 1 at the control visit, endocardial LS of the RV free wall (FW) (-19.3 [-17.9; -25.8] %) was significantly lower (Ñ=0.048) than in group 2 (-23.4 [-19.8; -27.8] %), and systolic pulmonary artery pressure (sPAP) according to C. Otto (32.0 [26.0; 35.0] mm Hg and 23.0 [20.0; 28.0]âmm Hg) was significantly higher than in group 2 (Ñ<0.001). According to the logistic regression, only endocardial RV FW LS (odds ratio, OR, 0.859; 95â% confidence interval, CI, 0.746-0.989; Ñ=0.034) and sPAP (OR, 1.248; 95â% CI, 1.108-1405; Ñ<0.001) were independently related with the increase in PVR. Spearman correlation analysis detected a moderate relationship between PVR and mean PAP according to G. Mahan (r=0.516; p=0.003) and between PVR and the index of right heart chamber functional coupling with the PA system (r=-0.509; p=0.007) in group 1 at the control visit.Conclusion In patients 3 months after COVID-19 pneumonia, hidden RV systolic dysfunction defined as depressed endocardial RV FW LS to -19.3% is associated with increased PVR ≥1.5 Wood units.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ventricular Dysfunction, Right
/
COVID-19
/
Cardiomyopathies
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Kardiologiia
Year:
2022
Document Type:
Article
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