Beyls Christophe, Ghesquières Tristan, Hermida Alexis, Booz Thomas, Crombet Maxime, Martin Nicolas, Huette Pierre, Jounieaux Vincent, Dupont Hervé, Abou-Arab Osama, Mahjoub Yazine
Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France.
UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France.
J Clin Med. 2022 Jun 23;11(13):3629. doi: 10.3390/jcm11133629.
Introduction: Right ventricular (RV) systolic dysfunction (RVsD) is a common complication of coronavirus infection 2019 disease (COVID-19). The right ventricular free wall longitudinal strain parameter (RV-FWLS) is a powerful predictor of mortality. We explored the performance of RVsD parameters for predicting 30-day mortality and the association between RV-FWLS and 30-day mortality. Methods: COVID-19 patients hospitalized at Amiens University Hospital in the critical care unit with transthoracic echocardiography were included. We measured tricuspid annular plane systolic excursion (TAPSE), the RV S’ wave, RV fractional area change (RV-FAC), and RV-FWLS. The diagnostic performance of RVsD parameters as predictors for 30-day mortality was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). RVsD was defined by an RV-FWLS < 21% to explore the association between RVsD and 30-day mortality. Results: Of the 116 patients included, 20% (n = 23/116) died and 47 had a RVsD. ROC curve analysis showed that RV-FWLS failed to predict 30-day mortality, as did conventional RV parameters (all p > 0.05). TAPSE (21 (19−26) mm vs. 24 (21−27) mm; p = 0.024) and RV-FAC (40 (35−47)% vs. 47 (41−55)%; p = 0.006) were lowered in the RVsD group. In Cox analysis, RVsD was not associated with 30-day mortality (hazard ratio = 1.12, CI 95% (0.49−2.55), p = 0.78). Conclusion: In severe COVID-19 pneumonia, RV-FWLS was not associated with 30-day mortality.
右心室收缩功能障碍（RVsD）是2019冠状病毒病（COVID-19）的常见并发症。右心室游离壁纵向应变参数（RV-FWLS）是死亡率的有力预测指标。我们探讨了RVsD参数预测30天死亡率的性能以及RV-FWLS与30天死亡率之间的关联。方法：纳入在亚眠大学医院重症监护病房住院并接受经胸超声心动图检查的COVID-19患者。我们测量了三尖瓣环平面收缩期位移（TAPSE）、右心室S’波、右心室面积变化分数（RV-FAC）和RV-FWLS。通过受试者操作特征（ROC）曲线下面积（AUC）评估RVsD参数作为30天死亡率预测指标的诊断性能。将RV-FWLS<21%定义为RVsD，以探讨RVsD与30天死亡率之间的关联。结果：在纳入的116例患者中，20%（n = 23/116）死亡，47例存在RVsD。ROC曲线分析表明，RV-FWLS未能预测30天死亡率，传统的右心室参数也是如此（所有p>0.05）。RVsD组的TAPSE（21（19 - 26）mm对24（21 - 27）mm；p = 0.024）和RV-FAC（40（35 - 47）%对47（41 - 55）%；p = 0.006）降低。在Cox分析中，RVsD与30天死亡率无关（风险比 = 1.12，95%CI（0.49 - 2.55），p = 0.78）。结论：在重症COVID-19肺炎中，RV-FWLS与3天死亡率无关。
