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住院的新冠病毒疾病(COVID-19)合并心血管事件患者的超声心动图特征、肌钙蛋白水平与生存时间之间的关联

Association between echocardiographic features, troponin levels, and survival time in hospitalized COVID-19 patients with cardiovascular events.

作者信息

Furmanek Stephen, Salunkhe Vidyulata, Pahwa Siddharth, Samanapally Harideep, Nathala Pavani, Xu Qian, Han Yuchen, Huang Emma C, Ali T'shura, Deepti Fnu, Glynn Alex, McGuffin Trevor, Huang Justin J, Farah Ian, Jones Christopher M, Ramirez Julio A, Clifford Sean P, Arnold Forest W, Kong Maiying, Roser Lynn, Huang Jiapeng

机构信息

Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), Department of Medicine, University of Louisville, 501 E Broadway, Louisville, KY 40202, USA.

Norton Infectious Diseases Institute, Norton Healthcare, 234 E Gray St, Louisville, KY 40202, USA.

出版信息

J Anesth Transl Med. 2024 Jun;3(2):36-44. doi: 10.1016/j.jatmed.2024.05.001. Epub 2024 May 8.

Abstract

INTRODUCTION

This study aims to explore the predictive roles of echocardiographic parameters and biomarkers in determining outcomes among hospitalized COVID-19 patients experiencing cardiovascular events.

METHODS

A retrospective cohort study was conducted involving 49 COVID-19 patients who encountered cardiovascular events during hospitalization and underwent echocardiography. Our findings revealed notable associations between echocardiographic parameters and survival time.

RESULTS

A decrease in left ventricular ejection fraction (LVEF) of 10% was linked to a 20% reduction in survival time (TR: 0.80, 95% CI: 0.67 - 0.96, p = .017). Similarly, an increase in left ventricular (LV) volume by 10 mL was associated with a 9% decrease in survival time (TR: 0.91, 95% CI: 0.84 - 0.98, p = .011). Moreover, an increase in left atrial (LA) volume by 10 mL corresponded to an 8% decrease in survival time (TR: 0.92, 95% CI: 0.86 - 0.99, p = .026). Additionally, each 1 cm increase in right ventricular (RV) diameter was linked to a 22% reduction in survival time (TR: 0.78, 95% CI: 0.61 - 0.99, p = .043). Furthermore, a 10 mL increase in right atrial (RA) volume was associated with a 12% decrease in survival time (TR: 0.88, 95% CI: 0.78 - 0.98, p = .017). Notably, a tenfold rise in troponin levels was linked to a 33% decrease in survival time (TR: 0.67, 95% CI: 0.48 - 0.93, p = .014).

CONCLUSIONS

Our study emphasizes the significant associations between various echocardiographic parameters and troponin levels with reduced survival time among COVID-19 patients experiencing cardiovascular events. These findings highlight the potential utility of echocardiography and troponin assessment in predicting outcomes and guiding management strategies in this patient population.

摘要

引言

本研究旨在探讨超声心动图参数和生物标志物在确定住院期间发生心血管事件的COVID-19患者预后方面的预测作用。

方法

进行了一项回顾性队列研究,纳入了49例在住院期间发生心血管事件并接受超声心动图检查的COVID-19患者。我们的研究结果揭示了超声心动图参数与生存时间之间的显著关联。

结果

左心室射血分数(LVEF)降低10%与生存时间缩短20%相关(风险比:0.80,95%置信区间:0.67 - 0.96,p = 0.017)。同样,左心室(LV)容积增加10 mL与生存时间缩短9%相关(风险比:0.91,95%置信区间:0.84 - 0.98,p = 0.011)。此外,左心房(LA)容积增加10 mL与生存时间缩短8%相关(风险比:0.92,95%置信区间:0.86 - 0.99,p = 0.026)。另外,右心室(RV)直径每增加1 cm与生存时间缩短22%相关(风险比:0.78,95%置信区间:0.61 - 0.99,p = 0.043)。此外,右心房(RA)容积增加10 mL与生存时间缩短12%相关(风险比:0.88,95%置信区间:0.78 - 0.98,p = 0.017)。值得注意的是,肌钙蛋白水平升高10倍与生存时间缩短33%相关(风险比:0.67,95%置信区间:0.48 - 0.93,p = 0.014)。

结论

我们的研究强调了各种超声心动图参数和肌钙蛋白水平与发生心血管事件的COVID-19患者生存时间缩短之间的显著关联。这些发现凸显了超声心动图和肌钙蛋白评估在预测该患者群体预后及指导管理策略方面的潜在效用。

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