Istanbul University-Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul,Turkey; University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Am J Emerg Med. 2021 Nov;49:1-5. doi: 10.1016/j.ajem.2021.05.039. Epub 2021 May 18.
COVID-19 spread worldwide, causing severe morbidity and mortality and this process still continues. The aim of this study to investigate the prognostic value of right ventricular (RV) strain in patients with COVID-19.
Consecutive adult patients admitted to the emergency room for COVID-19 between 1 and 30 April were included in this study. ECG was performed on hospital admission and was evaluated as blind. RV strain was defined as in the presence of one or more of the following ECG findings: complete or incomplete right ventricular branch block (RBBB), negative T wave in V1-V4 and presence of S1Q3T3. The main outcome measure was death during hospitalization. The relationship of variables to the main outcome was evaluated by multivariable Cox regression analysis.
A total of 324 patients with COVID-19 were included in the study; majority of patients were male (187, 58%) and mean age was 64.2 ± 14.1. Ninety-five patients (29%) had right ventricular strain according to ECG and 66 patients (20%) had died. After a multivariable survival analysis, presence of RV strain on ECG (OR: 4.385, 95%CI: 2.226-8.638, p < 0.001), high-sensitivity troponin I (hs-TnI), d-dimer and age were independent predictors of mortality.
Presence of right ventricular strain pattern on ECG is associated with in hospital mortality in patients with COVID-19.
COVID-19 在全球范围内传播，导致严重的发病率和死亡率，这一过程仍在继续。本研究旨在探讨右心室（RV）应变在 COVID-19 患者中的预后价值。
连续纳入 2020 年 4 月 1 日至 30 日因 COVID-19 入住急诊室的成年患者。入院时进行心电图检查，并进行盲法评估。RV 应变定义为存在以下心电图表现之一或多项：完全或不完全右束支阻滞（RBBB）、V1-V4 导联负 T 波和 S1Q3T3 征。主要观察指标为住院期间死亡。通过多变量 Cox 回归分析评估变量与主要结局的关系。
共纳入 324 例 COVID-19 患者；大多数患者为男性（187 例，58%），平均年龄为 64.2±14.1 岁。95 例（29%）患者根据心电图存在 RV 应变，66 例（20%）患者死亡。多变量生存分析后，心电图存在 RV 应变（OR：4.385，95%CI：2.226-8.638，p<0.001）、高敏肌钙蛋白 I（hs-TnI）、D-二聚体和年龄是死亡的独立预测因素。
心电图存在 RV 应变模式与 COVID-19 患者住院死亡率相关。
