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评价 COVID-19 出院患者左心室整体纵向应变与实验室参数的关系:一项随访研究。

Evaluation the relationship of left ventricular global longitudinal strain and laboratory parameters in discharged patients with COVID-19: a follow-up study.

机构信息

Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.

Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.

出版信息

Int J Cardiovasc Imaging. 2021 Aug;37(8):2451-2464. doi: 10.1007/s10554-021-02228-w. Epub 2021 Apr 7.

Abstract

BACKGROUND

The novel coronavirus infection (COVID-19) disease has spread rapidly and posed a great threat to global public health. The laboratory parameters and clinical outcomes of the disease in discharged patients remain unknown. In this study, we aimed to investigate the laboratory and echocardiographic findings of patients with COVID-19 after discharge and the relation between left ventricular global longitudinal strain (LVGLS) and inflammatory parameters in discharged patients.

METHODS

A total of 75 patients recovering from COVID-19 as the study group were prospectively recruited from the COVID-19 outpatient clinic for their follow-up visits at a median 6 months after discharge. Patients were classified into groups according to pneumonia severity and impairment in LVGLS. Laboratory findings of patients both at admission and after discharge were evaluated and the relation with pneumonia severity at admission and LVGLS after discharge were analyzed.

RESULTS

Serum ferritin, lactate dehydrogenase (LDH) and prohormone B-type natriuretic peptide (pro-BNP) levels after discharge were significantly higher in the study group than the control group (n = 44). Ferritin was found to be related to pneumonia severity. Serum ferritin and LDH values after discharge were significantly higher in patients with impaired LVGLS than those with preserved. There was a significant correlation between LVGLS, serum ferritin and LDH values after discharge (r = -0.252, p = 0.012; r = -0.268, p = 0.005, respectively).

CONCLUSIONS

Clinicians should pay close attention to the serum ferritin and LDH levels in discharged patients for predicting the severity of COVID-19 disease and early identification of subclinical left ventricular myocardial dysfunction.

摘要

背景

新型冠状病毒感染(COVID-19)疾病迅速传播,对全球公共卫生构成了巨大威胁。出院患者的疾病实验室参数和临床结果尚不清楚。在这项研究中,我们旨在研究 COVID-19 出院患者的实验室和超声心动图结果,以及出院患者左心室整体纵向应变(LVGLS)与炎症参数之间的关系。

方法

共有 75 名从 COVID-19 中康复的患者作为研究组,从 COVID-19 门诊前瞻性招募,在出院后中位数 6 个月进行随访。根据肺炎严重程度和 LVGLS 受损情况对患者进行分组。评估患者入院和出院后的实验室检查结果,并分析与入院时肺炎严重程度和出院后 LVGLS 的关系。

结果

出院后研究组患者的血清铁蛋白、乳酸脱氢酶(LDH)和脑钠肽前体(pro-BNP)水平明显高于对照组(n=44)。铁蛋白与肺炎严重程度有关。LVGLS 受损患者的出院后血清铁蛋白和 LDH 值明显高于 LVGLS 正常患者。出院后 LVGLS、血清铁蛋白和 LDH 值之间存在显著相关性(r=-0.252,p=0.012;r=-0.268,p=0.005)。

结论

临床医生应密切关注出院患者的血清铁蛋白和 LDH 水平,以预测 COVID-19 疾病的严重程度,并早期识别亚临床左心室心肌功能障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1cf/8025070/0efe543285e2/10554_2021_2228_Fig1_HTML.jpg

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