高动力性左心室射血分数与新冠病毒肺炎患者较高的死亡率相关。
Hyperdynamic left ventricular ejection fraction is associated with higher mortality in COVID-19 patients.
作者信息
Rahman Annas, Ruge Max, Hlepas Alex, Nair Gatha, Gomez Joanne, du Fay de Lavallaz Jeanne, Fugar Setri, Jahan Nusrat, Volgman Annabelle Santos, Williams Kim A, Rao Anupama, Marinescu Karolina, Suboc Tisha
机构信息
Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America.
Department of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, United States of America.
出版信息
Am Heart J Plus. 2022 Feb;14:100134. doi: 10.1016/j.ahjo.2022.100134. Epub 2022 Apr 18.
STUDY OBJECTIVE
To compare the characteristics and outcomes of COVID-19 patients with a hyperdynamic LVEF (HDLVEF) to those with a normal or reduced LVEF.
DESIGN
Retrospective study.
SETTING
Rush University Medical Center.
PARTICIPANTS
Of the 1682 adult patients hospitalized with COVID-19, 419 had a transthoracic echocardiogram (TTE) during admission and met study inclusion criteria.
INTERVENTIONS
Participants were divided into reduced (LVEF < 50%), normal (≥50% and <70%), and hyperdynamic (≥70%) LVEF groups.
MAIN OUTCOME MEASURES
LVEF was assessed as a predictor of 60-day mortality. Logistic regression was used to adjust for age and BMI.
RESULTS
There was no difference in 60-day mortality between patients in the reduced LVEF and normal LVEF groups (adjusted odds ratio [aOR] 0.87, = 0.68). However, patients with an HDLVEF were more likely to die by 60 days compared to patients in the normal LVEF group (aOR 2.63 [CI: 1.36-5.05]; < 0.01). The HDLVEF group was also at higher risk for 60-day mortality than the reduced LVEF group (aOR 3.34 [CI: 1.39-8.42]; p < 0.01).
CONCLUSION
The presence of hyperdynamic LVEF during a COVID-19 hospitalization was associated with an increased risk of 60-day mortality, the requirement for mechanical ventilation, vasopressors, and intensive care unit.
研究目的
比较左心室射血分数（LVEF）增高（HDLVEF）的新型冠状病毒肺炎（COVID-19）患者与LVEF正常或降低的患者的特征及预后。
设计
回顾性研究。
地点
拉什大学医学中心。
参与者
1682例因COVID-19住院的成年患者中，419例在入院期间接受了经胸超声心动图（TTE）检查并符合研究纳入标准。
干预措施
参与者被分为LVEF降低组（LVEF<50%）、正常组（≥50%且<70%）和高动力组（≥70%）。
主要结局指标
将LVEF评估为60天死亡率的预测指标。采用逻辑回归对年龄和体重指数进行校正。
结果
LVEF降低组和正常LVEF组患者的60天死亡率无差异（校正比值比[aOR]0.87，P=0.68）。然而，与正常LVEF组患者相比，HDLVEF患者60天内死亡的可能性更大（aOR 2.63[CI：1.36-5.05]；P<0.01）。HDLVEF组60天死亡率的风险也高于LVEF降低组（aOR 3.34[CI：1.39-8.42]；P<0.01）。
结论
COVID-19住院期间出现高动力LVEF与60天死亡率增加、机械通气、血管活性药物及重症监护病房需求增加相关。
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