tetano
Editor, Senior Moderator
J Clin Med
. 2023 May 23;12(11):3611.
doi: 10.3390/jcm12113611. Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
Federica Ilardi[SUP] 1 [/SUP], Mario Crisci[SUP] 2 [/SUP], Cecilia Calabrese[SUP] 3 [/SUP], Anna Scognamiglio[SUP] 2 [/SUP], Fortunato Arenga[SUP] 2 [/SUP], Rachele Manzo[SUP] 1 [/SUP], Domenica F Mariniello[SUP] 3 [/SUP], Valentino Allocca[SUP] 3 [/SUP], Anna Annunziata[SUP] 4 [/SUP], Antonello D'Andrea[SUP] 3 5 [/SUP], Raffaele Merenda[SUP] 2 [/SUP], Vittorio Monda[SUP] 2 [/SUP], Giovanni Esposito[SUP] 1 [/SUP], Giuseppe Fiorentino[SUP] 4 [/SUP]
Affiliations
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.
Keywords: COVID-19; pulmonary embolism; right-ventricle dysfunction; right-ventricle free wall longitudinal strain; right-ventricle global longitudinal strain.
. 2023 May 23;12(11):3611.
doi: 10.3390/jcm12113611. Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism
Federica Ilardi[SUP] 1 [/SUP], Mario Crisci[SUP] 2 [/SUP], Cecilia Calabrese[SUP] 3 [/SUP], Anna Scognamiglio[SUP] 2 [/SUP], Fortunato Arenga[SUP] 2 [/SUP], Rachele Manzo[SUP] 1 [/SUP], Domenica F Mariniello[SUP] 3 [/SUP], Valentino Allocca[SUP] 3 [/SUP], Anna Annunziata[SUP] 4 [/SUP], Antonello D'Andrea[SUP] 3 5 [/SUP], Raffaele Merenda[SUP] 2 [/SUP], Vittorio Monda[SUP] 2 [/SUP], Giovanni Esposito[SUP] 1 [/SUP], Giuseppe Fiorentino[SUP] 4 [/SUP]
Affiliations
- PMID: 37297806
- DOI: 10.3390/jcm12113611
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.
Keywords: COVID-19; pulmonary embolism; right-ventricle dysfunction; right-ventricle free wall longitudinal strain; right-ventricle global longitudinal strain.