Right ventricular free wall longitudinal strain assessment using offline speckle tracking in COVID-19 patients requiring intensive medical care.
J Med Ultrason (2001)
; 2023 Apr 20.
Article
in English
| MEDLINE | ID: covidwho-2300652
ABSTRACT
PURPOSE:
The purpose of this study was to evaluate and confirm the prognostic utility of comprehensive transthoracic echocardiography (TTE) using offline myocardial strain analyses in a Japanese coronavirus disease (COVID-19) cohort hospitalized in intensive care units.METHODS:
We performed a retrospective analysis of 90 consecutive adult patients with COVID-19 who underwent clinically indicated standard two-dimensional TTE in intensive care wards. Patients on extracorporeal membrane oxygenation (ECMO) at the time of TTE were excluded. Biventricular strain assessments using vendor-independent offline speckle tracking analysis were performed. Patients with inadequate TTE image quality were also excluded.RESULTS:
Among the 90 COVID-19 patients, 15 (17%) patients required venovenous or venoarterial ECMO. There were 25 (28%) in-hospital deaths. A composite event, defined as the combination of in-hospital mortality and subsequent initiation of ECMO, occurred in 32 patients. Multivariate logistic regression for composite events indicated that right ventricular free wall longitudinal strain (RV-FWLS) and mechanical ventilation at the time of TTE were independent risk factors for composite events (p = 0.01, odds ratio [OR] 1.09, 95% confidence interval [CI] 1.01-1.18; p = 0.04, OR 3.24, 95% CI 1.03-10.20). Cumulative survival probability plots generated using the Kaplan-Meier method for composite events with log-rank tests revealed a significant difference between subgroups divided by the cutoff value of RV-FWLS (p < 0.001).CONCLUSION:
Offline measurement of RV-FWLS may be a potent predictor of worse outcomes in COVID-19 requiring intensive care. Larger multicenter prospective studies are needed.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Language:
English
Year:
2023
Document Type:
Article
Affiliation country:
S10396-023-01305-y
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