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Cardiac function in relation to myocardial injury in hospitalised patients with COVID-19.
van den Heuvel, F M A; Vos, J L; Koop, Y; van Dijk, A P J; Duijnhouwer, A L; de Mast, Q; van de Veerdonk, F L; Bosch, F; Kok, B; Netea, M G; Hoogerwerf, J; Hoefsloot, W; Tjwa, E T T L; de Korte, C L; van Kimmenade, R R J; Nijveldt, R.
  • van den Heuvel FMA; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Vos JL; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Koop Y; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • van Dijk APJ; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Duijnhouwer AL; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • de Mast Q; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
  • van de Veerdonk FL; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Bosch F; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Kok B; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Netea MG; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Hoogerwerf J; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Hoefsloot W; Department of Pulmonology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Tjwa ETTL; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • de Korte CL; Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • van Kimmenade RRJ; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Nijveldt R; Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands. robin@nijveldt.net.
Neth Heart J ; 28(7-8): 410-417, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-635095
ABSTRACT

BACKGROUND:

Previous studies have reported on myocardial injury in patients with coronavirus infectious disease 19 (COVID-19) defined as elevated cardiac biomarkers. Whether elevated biomarkers truly represent myocardial dysfunction is not known. The aim of this study was to explore the incidence of ventricular dysfunction and assess its relationship with biomarker analyses.

METHODS:

This cross-sectional study ran from April 1 to May 12, 2020, and consisted of all consecutively admitted patients to the Radboud university medical centre nursing ward for COVID-19. Laboratory assessment included high-sensitivity Troponin T and N­terminal pro-B-type natriuretic peptide (NT-proBNP). Echocardiographic evaluation focused on left and right ventricular systolic function and global longitudinal strain (GLS).

RESULTS:

In total, 51 patients were included, with a median age of 63 years (range 51-68 years) of whom 80% was male. Troponin T was elevated (>14 ng/l) in 47%, and a clinically relevant Troponin T elevation (10â€¯× URL) was found in three patients (6%). NT-proBNP was elevated (>300 pg/ml) in 24 patients (47%), and in four (8%) the NT-proBNP concentration was >1,000 pg/ml. Left ventricular dysfunction (ejection fraction <52% and/or GLS >-18%) was observed in 27%, while right ventricular dysfunction (TAPSE <17 mm and/or RV S' < 10 cm/s) was seen in 10%. There was no association between elevated Troponin T or NT-proBNP and left or right ventricular dysfunction. Patients with confirmed pulmonary embolism had normal right ventricular function.

CONCLUSIONS:

In hospitalised patients, it seems that COVID-19 predominantly affects the respiratory system, while cardiac dysfunction occurs less often. Based on a single echocardiographic evaluation, we found no relation between elevated Troponin T or NT-proBNP, and ventricular dysfunction. Echocardiography has limited value in screening for ventricular dysfunction.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Neth Heart J Year: 2020 Document Type: Article Affiliation country: S12471-020-01458-2

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Neth Heart J Year: 2020 Document Type: Article Affiliation country: S12471-020-01458-2