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Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19
BACKGROUND: Cardiac function of critically ill patients with COVID-19 generally has been reported from clinically obtained data. Echocardiographic deformation imaging can identify ventricular dysfunction missed by traditional echocardiographic assessment. RESEARCH QUESTION: What is the prevalence of...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier Inc under license from the American College of Chest Physicians.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030437/ https://www.ncbi.nlm.nih.gov/pubmed/38014378 http://dx.doi.org/10.1016/j.chstcc.2023.100002 |
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author | Lanspa, Michael J. Dugar, Siddharth P. Prigmore, Heather L. Boyd, Jeremy S. Rupp, Jordan D. Lindsell, Chris J. Rice, Todd W. Qadir, Nida Lim, George W. Shiloh, Ariel L. Dieiev, Vladyslav Gong, Michelle N. Fox, Steven W. Hirshberg, Eliotte L. Khan, Akram Kornfield, James Schoeneck, Jacob H. Macklin, Nicholas Files, D.Clark Gibbs, Kevin W. Prekker, Matthew E. Parsons-Moss, Daniel Bown, Mikaele Olsen, Troy D. Knox, Daniel B. Cirulis, Meghan M. Mehkri, Omar Duggal, Abhijit Tenforde, Mark W. Patel, Manish M. Self, Wesley H. Brown, Samuel M. |
author_facet | Lanspa, Michael J. Dugar, Siddharth P. Prigmore, Heather L. Boyd, Jeremy S. Rupp, Jordan D. Lindsell, Chris J. Rice, Todd W. Qadir, Nida Lim, George W. Shiloh, Ariel L. Dieiev, Vladyslav Gong, Michelle N. Fox, Steven W. Hirshberg, Eliotte L. Khan, Akram Kornfield, James Schoeneck, Jacob H. Macklin, Nicholas Files, D.Clark Gibbs, Kevin W. Prekker, Matthew E. Parsons-Moss, Daniel Bown, Mikaele Olsen, Troy D. Knox, Daniel B. Cirulis, Meghan M. Mehkri, Omar Duggal, Abhijit Tenforde, Mark W. Patel, Manish M. Self, Wesley H. Brown, Samuel M. |
author_sort | Lanspa, Michael J. |
collection | PubMed |
description | BACKGROUND: Cardiac function of critically ill patients with COVID-19 generally has been reported from clinically obtained data. Echocardiographic deformation imaging can identify ventricular dysfunction missed by traditional echocardiographic assessment. RESEARCH QUESTION: What is the prevalence of ventricular dysfunction and what are its implications for the natural history of critical COVID-19? STUDY DESIGN AND METHODS: This is a multicenter prospective cohort of critically ill patients with COVID-19. We performed serial echocardiography and lower extremity vascular ultrasound on hospitalization days 1, 3, and 8. We defined left ventricular (LV) dysfunction as the absolute value of longitudinal strain of < 17% or left ventricle ejection fraction (LVEF) of < 50%. Primary clinical outcome was inpatient survival. RESULTS: We enrolled 110 patients. Thirty-nine (35.5%) died before hospital discharge. LV dysfunction was present at admission in 38 patients (34.5%) and in 21 patients (36.2%) on day 8 (P = .59). Median baseline LVEF was 62% (interquartile range [IQR], 52%-69%), whereas median absolute value of baseline LV strain was 16% (IQR, 14%-19%). Survivors and nonsurvivors did not differ statistically significantly with respect to day 1 LV strain (17.9% vs 14.4%; P = .12) or day 1 LVEF (60.5% vs 65%; P = .06). Nonsurvivors showed worse day 1 right ventricle (RV) strain than survivors (16.3% vs 21.2%; P = .04). INTERPRETATION: Among patients with critical COVID-19, LV and RV dysfunction is common, frequently identified only through deformation imaging, and early (day 1) RV dysfunction may be associated with clinical outcome. |
format | Online Article Text |
id | pubmed-10030437 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Authors. Published by Elsevier Inc under license from the American College of Chest Physicians. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100304372023-03-22 Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 Lanspa, Michael J. Dugar, Siddharth P. Prigmore, Heather L. Boyd, Jeremy S. Rupp, Jordan D. Lindsell, Chris J. Rice, Todd W. Qadir, Nida Lim, George W. Shiloh, Ariel L. Dieiev, Vladyslav Gong, Michelle N. Fox, Steven W. Hirshberg, Eliotte L. Khan, Akram Kornfield, James Schoeneck, Jacob H. Macklin, Nicholas Files, D.Clark Gibbs, Kevin W. Prekker, Matthew E. Parsons-Moss, Daniel Bown, Mikaele Olsen, Troy D. Knox, Daniel B. Cirulis, Meghan M. Mehkri, Omar Duggal, Abhijit Tenforde, Mark W. Patel, Manish M. Self, Wesley H. Brown, Samuel M. CHEST Critical Care Sepsis and Infections: Original Research BACKGROUND: Cardiac function of critically ill patients with COVID-19 generally has been reported from clinically obtained data. Echocardiographic deformation imaging can identify ventricular dysfunction missed by traditional echocardiographic assessment. RESEARCH QUESTION: What is the prevalence of ventricular dysfunction and what are its implications for the natural history of critical COVID-19? STUDY DESIGN AND METHODS: This is a multicenter prospective cohort of critically ill patients with COVID-19. We performed serial echocardiography and lower extremity vascular ultrasound on hospitalization days 1, 3, and 8. We defined left ventricular (LV) dysfunction as the absolute value of longitudinal strain of < 17% or left ventricle ejection fraction (LVEF) of < 50%. Primary clinical outcome was inpatient survival. RESULTS: We enrolled 110 patients. Thirty-nine (35.5%) died before hospital discharge. LV dysfunction was present at admission in 38 patients (34.5%) and in 21 patients (36.2%) on day 8 (P = .59). Median baseline LVEF was 62% (interquartile range [IQR], 52%-69%), whereas median absolute value of baseline LV strain was 16% (IQR, 14%-19%). Survivors and nonsurvivors did not differ statistically significantly with respect to day 1 LV strain (17.9% vs 14.4%; P = .12) or day 1 LVEF (60.5% vs 65%; P = .06). Nonsurvivors showed worse day 1 right ventricle (RV) strain than survivors (16.3% vs 21.2%; P = .04). INTERPRETATION: Among patients with critical COVID-19, LV and RV dysfunction is common, frequently identified only through deformation imaging, and early (day 1) RV dysfunction may be associated with clinical outcome. The Authors. Published by Elsevier Inc under license from the American College of Chest Physicians. 2023-06 2023-03-22 /pmc/articles/PMC10030437/ /pubmed/38014378 http://dx.doi.org/10.1016/j.chstcc.2023.100002 Text en © 2023 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Sepsis and Infections: Original Research Lanspa, Michael J. Dugar, Siddharth P. Prigmore, Heather L. Boyd, Jeremy S. Rupp, Jordan D. Lindsell, Chris J. Rice, Todd W. Qadir, Nida Lim, George W. Shiloh, Ariel L. Dieiev, Vladyslav Gong, Michelle N. Fox, Steven W. Hirshberg, Eliotte L. Khan, Akram Kornfield, James Schoeneck, Jacob H. Macklin, Nicholas Files, D.Clark Gibbs, Kevin W. Prekker, Matthew E. Parsons-Moss, Daniel Bown, Mikaele Olsen, Troy D. Knox, Daniel B. Cirulis, Meghan M. Mehkri, Omar Duggal, Abhijit Tenforde, Mark W. Patel, Manish M. Self, Wesley H. Brown, Samuel M. Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title | Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title_full | Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title_fullStr | Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title_full_unstemmed | Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title_short | Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19 |
title_sort | early serial echocardiographic and ultrasonographic findings in critically ill patients with covid-19 |
topic | Sepsis and Infections: Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10030437/ https://www.ncbi.nlm.nih.gov/pubmed/38014378 http://dx.doi.org/10.1016/j.chstcc.2023.100002 |
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