Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pulmonary Medicine, Clinical Research and Development Center, Shahid Modarres Hospital, Tehran, Iran.
Clin Cardiol. 2021 Oct;44(10):1475-1481. doi: 10.1002/clc.23708. Epub 2021 Aug 6.
Recent reports have indicated the beneficial role of strain measurement in COVID-19 patients.
To determine the association between right and left global longitudinal strain (RVGLS, LVGLS) and COVID-19 patients' outcomes.
Hospitalized COVID-19 patients between June and August 2020 were included. Two-dimensional echocardiography and biventricular global longitudinal strain measurement were performed. The outcome measure was defined as mortality, ICU admission, and need for intubation. Appropriate statistical tests were used to compare different groups.
In this study 207 patients (88 females) were enrolled. During 64 ± 4 days of follow-up, 22 (10.6%) patients died. Mortality, ICU admission, and intubation were significantly associated with LVGLS and RVGLS tertiles. LVGLS tertiles could predict poor outcome with significant odds ratios in the total population (OR = 0.203, 95% CI: 0.088-0.465; OR = 0.350, 95% CI: 0.210-0.585; OR = 0.354, 95% CI: 0.170-0.736 for mortality, ICU admission, and intubation). Although odds ratios of LVGLS for the prediction of outcome were statistically significant among hypertensive patients, these odds ratios did not reach significance among non-hypertensive patients. RVGLS tertiles revealed significant odds ratios for the prediction of mortality (OR = 0.322, 95% CI: 0.162-0.640), ICU admission (OR = 0.287, 95% CI: 0.166-0.495), and need for intubation (OR = 0.360, 95% CI: 0.174-0.744). Odds ratios of RVGLS remained significant even after adjusting for hypertension when considering mortality and ICU admission.
RVGLS and LVGLS can be acceptable prognostic factors to predict mortality, ICU admission, and intubation in hospitalized COVID-19 patients. However, RVGLS seems more reliable, as it is not confounded by hypertension.
最近的报告表明应变测量在 COVID-19 患者中的有益作用。
确定右室和左室整体纵向应变（RVGLS、LVGLS）与 COVID-19 患者结局之间的关系。
纳入 2020 年 6 月至 8 月期间住院的 COVID-19 患者。进行二维超声心动图和双心室整体纵向应变测量。结局定义为死亡率、入住 ICU 和需要插管。使用适当的统计检验比较不同组。
本研究共纳入 207 例（88 例女性）患者。在 64±4 天的随访期间，22 例（10.6%）患者死亡。死亡率、入住 ICU 和插管与 LVGLS 和 RVGLS 三分位数显著相关。LVGLS 三分位数可预测总人群不良结局，具有显著的优势比（OR=0.203，95%CI：0.088-0.465；OR=0.350，95%CI：0.210-0.585；OR=0.354，95%CI：0.170-0.736 用于死亡率、ICU 入院和插管）。尽管 LVGLS 预测结局的优势比在高血压患者中有统计学意义，但在非高血压患者中优势比无统计学意义。RVGLS 三分位数对死亡率（OR=0.322，95%CI：0.162-0.640）、ICU 入院（OR=0.287，95%CI：0.166-0.495）和插管需求（OR=0.360，95%CI：0.174-0.744）的预测具有显著的优势比。考虑死亡率和 ICU 入院时，即使在调整高血压后，RVGLS 的优势比仍然具有统计学意义。
RVGLS 和 LVGLS 可作为预测 COVID-19 住院患者死亡率、入住 ICU 和插管的可接受预后因素。然而，RVGLS 似乎更可靠，因为它不受高血压的影响。
