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Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism

The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-C...

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Autores principales: Ilardi, Federica, Crisci, Mario, Calabrese, Cecilia, Scognamiglio, Anna, Arenga, Fortunato, Manzo, Rachele, Mariniello, Domenica F., Allocca, Valentino, Annunziata, Anna, D’Andrea, Antonello, Merenda, Raffaele, Monda, Vittorio, Esposito, Giovanni, Fiorentino, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253748/
https://www.ncbi.nlm.nih.gov/pubmed/37297806
http://dx.doi.org/10.3390/jcm12113611
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author Ilardi, Federica
Crisci, Mario
Calabrese, Cecilia
Scognamiglio, Anna
Arenga, Fortunato
Manzo, Rachele
Mariniello, Domenica F.
Allocca, Valentino
Annunziata, Anna
D’Andrea, Antonello
Merenda, Raffaele
Monda, Vittorio
Esposito, Giovanni
Fiorentino, Giuseppe
author_facet Ilardi, Federica
Crisci, Mario
Calabrese, Cecilia
Scognamiglio, Anna
Arenga, Fortunato
Manzo, Rachele
Mariniello, Domenica F.
Allocca, Valentino
Annunziata, Anna
D’Andrea, Antonello
Merenda, Raffaele
Monda, Vittorio
Esposito, Giovanni
Fiorentino, Giuseppe
author_sort Ilardi, Federica
collection PubMed
description The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-CoV-2 pneumonia followed up for one year, 44 patients (mean age 58.4 ± 13.3, 70% males) without known cardiopulmonary disease were divided in two groups (PE+ and PE−, each comprising 22 patients) and underwent clinical and transthoracic echocardiographic examination, including right-ventricle global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RV-FWLS). While no significant differences were found in the left- or right-heart chambers’ dimensions between the two study groups, the PE+ patients showed a significant reduction in RV-GLS (−16.4 ± 2.9 vs. −21.6 ± 4.3%, p < 0.001) and RV-FWLS (−18.9 ± 4 vs. −24.6 ± 5.12%, p < 0.001) values compared to the PE- patients. According to the ROC-curve analysis, RV-FWLS < 21% was the best cut-off with which to predict PE diagnosis in patients after SARS-CoV-2 pneumonia (sensitivity 74%, specificity 89%, area under the curve = 0.819, p < 0.001). According to the multivariate logistic regression model, RV-FWLS < 21% was independently associated with PE (HR 34.96, 95% CI:3.24–377.09, p = 0.003) and obesity (HR 10.34, 95% CI:1.05–101.68, p = 0.045). In conclusion, in recovered COVID-19 patients with a history of PE+, there is a persistence of subclinical RV dysfunction one year after the acute phase of the disease, detectable by a significant impairment in RV-GLS and RV-FWLS. A reduction in RV-FWLS of lower than 21% is independently associated with COVID-related PE.
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spelling pubmed-102537482023-06-10 Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism Ilardi, Federica Crisci, Mario Calabrese, Cecilia Scognamiglio, Anna Arenga, Fortunato Manzo, Rachele Mariniello, Domenica F. Allocca, Valentino Annunziata, Anna D’Andrea, Antonello Merenda, Raffaele Monda, Vittorio Esposito, Giovanni Fiorentino, Giuseppe J Clin Med Article The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-CoV-2 pneumonia followed up for one year, 44 patients (mean age 58.4 ± 13.3, 70% males) without known cardiopulmonary disease were divided in two groups (PE+ and PE−, each comprising 22 patients) and underwent clinical and transthoracic echocardiographic examination, including right-ventricle global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RV-FWLS). While no significant differences were found in the left- or right-heart chambers’ dimensions between the two study groups, the PE+ patients showed a significant reduction in RV-GLS (−16.4 ± 2.9 vs. −21.6 ± 4.3%, p < 0.001) and RV-FWLS (−18.9 ± 4 vs. −24.6 ± 5.12%, p < 0.001) values compared to the PE- patients. According to the ROC-curve analysis, RV-FWLS < 21% was the best cut-off with which to predict PE diagnosis in patients after SARS-CoV-2 pneumonia (sensitivity 74%, specificity 89%, area under the curve = 0.819, p < 0.001). According to the multivariate logistic regression model, RV-FWLS < 21% was independently associated with PE (HR 34.96, 95% CI:3.24–377.09, p = 0.003) and obesity (HR 10.34, 95% CI:1.05–101.68, p = 0.045). In conclusion, in recovered COVID-19 patients with a history of PE+, there is a persistence of subclinical RV dysfunction one year after the acute phase of the disease, detectable by a significant impairment in RV-GLS and RV-FWLS. A reduction in RV-FWLS of lower than 21% is independently associated with COVID-related PE. MDPI 2023-05-23 /pmc/articles/PMC10253748/ /pubmed/37297806 http://dx.doi.org/10.3390/jcm12113611 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ilardi, Federica
Crisci, Mario
Calabrese, Cecilia
Scognamiglio, Anna
Arenga, Fortunato
Manzo, Rachele
Mariniello, Domenica F.
Allocca, Valentino
Annunziata, Anna
D’Andrea, Antonello
Merenda, Raffaele
Monda, Vittorio
Esposito, Giovanni
Fiorentino, Giuseppe
Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title_full Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title_fullStr Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title_full_unstemmed Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title_short Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
title_sort effects on right ventricular function one year after covid-19-related pulmonary embolism
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253748/
https://www.ncbi.nlm.nih.gov/pubmed/37297806
http://dx.doi.org/10.3390/jcm12113611
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