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超声心动图和心电图在 COVID-19 患者中的表现:一项横断面研究。

Echocardiographic and electrocardiographic findings in COVID-19 patients: a cross-sectional study.

机构信息

Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Int J Cardiovasc Imaging. 2022 Oct;38(10):2167-2175. doi: 10.1007/s10554-022-02617-9. Epub 2022 Apr 26.

Abstract

There are still many gaps in our knowledge regarding the direct cardiovascular injuries due to COVID-19 infection. In this study, we tried to find out the effect of SARS-CoV-2 infection on cardiac function in patients without any history of structural heart disease by electrocardiographic and echocardiographic evaluations. This was a cross-sectional study on patients with COVID-19 infection admitted to Imam Reza hospital, Mashhad, Iran between 14 April and 21 September 2020. COVID-19 infection was verified by a positive reverse-transcriptase polymerase chain reaction (PCR) assay for SARS-CoV-2 using nasopharyngeal/oropharyngeal samples. We enrolled all patients over 18 years old with definite diagnosis of COVID-19 infection. All patients underwent a comprehensive transthoracic echocardiography at the first week of admission. Clinical and imaging data were collected prospectively. In total, 142 patients were enrolled in this study. The mean age of participants was 60.69 ± 15.70 years (range: 30-90 years). Most patients were male (82, 57.7%). Multivariate analysis showed that O2 saturation at admission was independently a predictor of re-hospitalization (P < 0.001). RV size (P < 0.001), dyslipidemia (P < 0.001), ejection fraction (EF) (P < 0.001), age (P = 0.020), systolic blood pressure (P = 0.001), O2 saturation (P = 0.018) and diabetes (P = 0.025) independently predicted 30-days mortality. Echocardiography can be used for risk assessment in patients with COVID-19, especially in those with previous history of diabetes and dyslipidemia. The infection could result in ventricular dysfunction, even in those without previous history of structural heart disease.

摘要

关于 COVID-19 感染导致的直接心血管损伤,我们的知识仍存在许多空白。在这项研究中,我们试图通过心电图和超声心动图评估,找出 SARS-CoV-2 感染对无结构性心脏病病史患者心功能的影响。这是一项在 2020 年 4 月 14 日至 9 月 21 日期间入住伊朗马什哈德伊玛目礼萨医院的 COVID-19 感染患者的横断面研究。通过鼻咽/口咽样本对 SARS-CoV-2 的逆转录酶聚合酶链反应(PCR)检测呈阳性来证实 COVID-19 感染。我们纳入了所有年龄在 18 岁以上、明确诊断为 COVID-19 感染的患者。所有患者在入院第一周内接受全面的经胸超声心动图检查。前瞻性收集临床和影像学数据。共有 142 例患者纳入本研究。参与者的平均年龄为 60.69±15.70 岁(范围:30-90 岁)。大多数患者为男性(82 例,57.7%)。多变量分析显示,入院时的氧饱和度是再入院的独立预测因素(P<0.001)。右心室大小(P<0.001)、血脂异常(P<0.001)、射血分数(EF)(P<0.001)、年龄(P=0.020)、收缩压(P=0.001)、氧饱和度(P=0.018)和糖尿病(P=0.025)独立预测 30 天死亡率。超声心动图可用于 COVID-19 患者的风险评估,尤其是那些有糖尿病和血脂异常病史的患者。感染可导致心室功能障碍,即使在无结构性心脏病病史的患者中也是如此。

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本文引用的文献

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In the eye of the storm: the right ventricle in COVID-19.风暴之眼:新型冠状病毒肺炎中的右心室
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Acute myocarditis associated with COVID-19 infection.与 COVID-19 感染相关的急性心肌炎。
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Echocardiographic Findings in Patients With COVID-19 Pneumonia.新型冠状病毒肺炎患者的超声心动图表现。
Can J Cardiol. 2020 Aug;36(8):1203-1207. doi: 10.1016/j.cjca.2020.05.030. Epub 2020 May 28.
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Right Ventricular Dilation in Hospitalized Patients With COVID-19 Infection.新型冠状病毒肺炎(COVID-19)感染住院患者的右心室扩张
JACC Cardiovasc Imaging. 2020 Nov;13(11):2459-2461. doi: 10.1016/j.jcmg.2020.05.010. Epub 2020 May 15.

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