Martha Januar Wibawa, Pranata Raymond, Wibowo Arief, Lim Michael Anthonius
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Indonesia; Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Int J Infect Dis. 2021 Apr;105:351-356. doi: 10.1016/j.ijid.2021.02.029. Epub 2021 Feb 11.
In this systematic review and meta-analysis, we assessed the association between tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography and mortality in coronavirus disease 2019 (COVID-19).
We performed a systematic literature search using PubMed, Embase, and Scopus databases with the keywords "COVID-19" OR "SARS-CoV-2" OR "2019-nCoV" AND "Tricuspid annular plane systolic excursion" OR "TAPSE" until January 20, 2021. The main outcome was mortality. The effect estimate was reported as the hazard ratio (HR), which was pooled from the unadjusted and adjusted effect estimates retrieved from the studies included. Mean differences in TAPSE (in mm) between non-survivors and survivors were pooled.
In total, 641 patients from seven studies were included in this systematic review and meta-analysis. TAPSE was lower in non-survivors compared with survivors (mean difference = -3.74 [-5.22, -2.26], p < 0.001; I: 85.5%, p < 0.001). Each 1 mm decrease in TAPSE was associated with increased mortality (HR = 1.24 [1.18, 1.31], p < 0.001; I: 0.0%, p = 0.491). In the pooled adjusted model, each 1 mm decrease in TAPSE was associated with increased mortality (HR = 1.21 [1.11, 1.33], p < 0.001; I: 45.1%, p = 0.156). Meta-regression indicated that the difference in TAPSE between non-survivors and survivors was affected by chronic obstructive pulmonary disease (-0.183, p < 0.001) and pulmonary artery systolic pressure (-0.344, p = 0.039), but not by age (p = 0.668), male gender (p = 0.821), hypertension (p = 0.101), diabetes (p = 0.603), coronary artery disease (p = 0.564), smoking (p = 0.140), and left ventricular ejection fraction (p = 0.452).
Every 1 mm decrease in TAPSE was associated with an increase in mortality of approximately 20%.
CRD42021232194.
在本系统评价和荟萃分析中，我们评估了通过超声心动图测量的三尖瓣环平面收缩期位移（TAPSE）与2019冠状病毒病（COVID-19）死亡率之间的关联。
我们使用PubMed、Embase和Scopus数据库进行系统文献检索，关键词为“COVID-19”或“SARS-CoV-2”或“2019-nCoV”以及“三尖瓣环平面收缩期位移”或“TAPSE”，检索截至2021年1月20日。主要结局为死亡率。效应估计值报告为风险比（HR），其汇总自纳入研究中检索到的未调整和调整后的效应估计值。汇总了非幸存者与幸存者之间TAPSE（单位：mm）的平均差异。
本系统评价和荟萃分析共纳入了来自7项研究的641例患者。与幸存者相比，非幸存者的TAPSE较低（平均差异=-3.74[-5.22，-2.26]，p<0.001；I²=85.5%，p<0.001）。TAPSE每降低1mm与死亡率增加相关（HR=1.24[1.18，1.31]，p<0.001；I²=0.0%，p=0.491）。在汇总的调整模型中，TAPSE每降低1mm与死亡率增加相关（HR=1.21[1.11，1.33]，p<0.001；I²=45.1%，p=0.156）。Meta回归表明，非幸存者与幸存者之间TAPSE的差异受慢性阻塞性肺疾病（-0.183，p<0.001）和肺动脉收缩压（-0.344，p=0.039）影响，但不受年龄（p=0.668）、男性（p=0.821）、高血压（p=0.101）、糖尿病（p=0.603）、冠状动脉疾病（p=0.564）、吸烟（p=0.140）和左心室射血分数（p=0.452）影响。
TAPSE每降低1mm与死亡率增加约20%相关。
PROSPERO注册号：CRD42021232194。
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