tetano
Editor, Senior Moderator
Heart
. 2020 Jul 16;heartjnl-2020-317355.
doi: 10.1136/heartjnl-2020-317355. Online ahead of print.
Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19
Matteo Pagnesi[SUP] #[/SUP][SUP] 1 [/SUP], Luca Baldetti[SUP] #[/SUP][SUP] 2 [/SUP], Alessandro Beneduce[SUP] 3 [/SUP], Francesco Calvo[SUP] 2 [/SUP], Mario Gramegna[SUP] 2 [/SUP], Vittorio Pazzanese[SUP] 2 [/SUP], Giacomo Ingallina[SUP] 4 [/SUP], Antonio Napolano[SUP] 4 [/SUP], Renato Finazzi[SUP] 5 [/SUP], Annalisa Ruggeri[SUP] 6 [/SUP], Silvia Ajello[SUP] 7 [/SUP], Giulio Melisurgo[SUP] 7 [/SUP], Paolo Guido Camici[SUP] 8 [/SUP], Paolo Scarpellini[SUP] 9 [/SUP], Moreno Tresoldi[SUP] 5 [/SUP], Giovanni Landoni[SUP] 8 10 [/SUP], Fabio Ciceri[SUP] 6 8 [/SUP], Anna Mara Scandroglio[SUP] 7 10 [/SUP], Eustachio Agricola[SUP] 4 8 [/SUP], Alberto Maria Cappelletti[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: To assess the prevalence, characteristics and prognostic value of pulmonary hypertension (PH) and right ventricular dysfunction (RVD) in hospitalised, non-intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19).
Methods: This single-centre, observational, cross-sectional study included 211 patients with COVID-19 admitted to non-ICU departments who underwent a single transthoracic echocardiography (TTE). Patients with poor acoustic window (n=11) were excluded. Clinical, imaging, laboratory and TTE findings were compared in patients with versus without PH (estimated systolic pulmonary artery pressure >35 mm Hg) and with versus without RVD (tricuspid annular plane systolic excursion <17 mm or S wave <9.5 cm/s). The primary endpoint was in-hospital death or ICU admission.
Results: A total of 200 patients were included in the final analysis (median age 62 (IQR 52-74) years, 65.5% men). The prevalence of PH and RVD was 12.0% (24/200) and 14.5% (29/200), respectively. Patients with PH were older and had a higher burden of pre-existing cardiac comorbidities and signs of more severe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (radiological lung involvement, laboratory findings and oxygenation status) compared with those without PH. Conversely, patients with RVD had a higher burden of pre-existing cardiac comorbidities but no evidence of more severe SARS-CoV-2 infection compared with those without RVD. The presence of PH was associated with a higher rate of in-hospital death or ICU admission (41.7 vs 8.5%, p<0.001), while the presence of RVD was not (17.2 vs 11.7%, p=0.404).
Conclusions: Among hospitalised non-ICU patients with COVID-19, PH (and not RVD) was associated with signs of more severe COVID-19 and with worse in-hospital clinical outcome.
. 2020 Jul 16;heartjnl-2020-317355.
doi: 10.1136/heartjnl-2020-317355. Online ahead of print.
Pulmonary hypertension and right ventricular involvement in hospitalised patients with COVID-19
Matteo Pagnesi[SUP] #[/SUP][SUP] 1 [/SUP], Luca Baldetti[SUP] #[/SUP][SUP] 2 [/SUP], Alessandro Beneduce[SUP] 3 [/SUP], Francesco Calvo[SUP] 2 [/SUP], Mario Gramegna[SUP] 2 [/SUP], Vittorio Pazzanese[SUP] 2 [/SUP], Giacomo Ingallina[SUP] 4 [/SUP], Antonio Napolano[SUP] 4 [/SUP], Renato Finazzi[SUP] 5 [/SUP], Annalisa Ruggeri[SUP] 6 [/SUP], Silvia Ajello[SUP] 7 [/SUP], Giulio Melisurgo[SUP] 7 [/SUP], Paolo Guido Camici[SUP] 8 [/SUP], Paolo Scarpellini[SUP] 9 [/SUP], Moreno Tresoldi[SUP] 5 [/SUP], Giovanni Landoni[SUP] 8 10 [/SUP], Fabio Ciceri[SUP] 6 8 [/SUP], Anna Mara Scandroglio[SUP] 7 10 [/SUP], Eustachio Agricola[SUP] 4 8 [/SUP], Alberto Maria Cappelletti[SUP] 2 [/SUP]
Affiliations
- PMID: 32675217
- DOI: 10.1136/heartjnl-2020-317355
Abstract
Objective: To assess the prevalence, characteristics and prognostic value of pulmonary hypertension (PH) and right ventricular dysfunction (RVD) in hospitalised, non-intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19).
Methods: This single-centre, observational, cross-sectional study included 211 patients with COVID-19 admitted to non-ICU departments who underwent a single transthoracic echocardiography (TTE). Patients with poor acoustic window (n=11) were excluded. Clinical, imaging, laboratory and TTE findings were compared in patients with versus without PH (estimated systolic pulmonary artery pressure >35 mm Hg) and with versus without RVD (tricuspid annular plane systolic excursion <17 mm or S wave <9.5 cm/s). The primary endpoint was in-hospital death or ICU admission.
Results: A total of 200 patients were included in the final analysis (median age 62 (IQR 52-74) years, 65.5% men). The prevalence of PH and RVD was 12.0% (24/200) and 14.5% (29/200), respectively. Patients with PH were older and had a higher burden of pre-existing cardiac comorbidities and signs of more severe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (radiological lung involvement, laboratory findings and oxygenation status) compared with those without PH. Conversely, patients with RVD had a higher burden of pre-existing cardiac comorbidities but no evidence of more severe SARS-CoV-2 infection compared with those without RVD. The presence of PH was associated with a higher rate of in-hospital death or ICU admission (41.7 vs 8.5%, p<0.001), while the presence of RVD was not (17.2 vs 11.7%, p=0.404).
Conclusions: Among hospitalised non-ICU patients with COVID-19, PH (and not RVD) was associated with signs of more severe COVID-19 and with worse in-hospital clinical outcome.