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新冠康复患者右心室后遗症的斑点追踪超声心动图评估

Assessment of right ventricular sequelae by speckle tracking echocardiography in recovered COVID-19 patients.

作者信息

Parsova Kemal Emrecan, Keles Nursen, Karatas Mesut, Karatas Mehmet Baran, Kahraman Erkan, Durak Furkan, Kocogulları Cevdet Ugur

机构信息

Deparment of Cardiology, Koc University Hospital, Istanbul, Turkey.

Department of Cardiology, University of Health Sciences, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Acta Cardiol. 2024 Oct;79(8):909-914. doi: 10.1080/00015385.2024.2398840. Epub 2024 Sep 12.

Abstract

BACKGROUND

TTE is the main modality used to assess RV function, but conventional TTE parameters have limited diagnostic value because they may fail to detect early abnormalities in RV systolic function. Due to its ability to detect subclinical impairment of cardiac function, 2D STE has been widely used to investigate RV function. In this study, we aimed to investigate whether there are sequelae of RV function in recovered COVID-19 patients with pulmonary involvement.

METHODS

This is a prospective observational cohort study of 57 healthy volunteers and 54 patients. Participants had no history of chronic illness and no evidence of respiratory or cardiac symptoms. The patients had been hospitalised with COVID-19 with pulmonary involvement but did not require intensive care unit follow-up or non-invasive mechanical ventilation support. TTE was performed. Demographic and clinical characteristics and laboratory test results were collected.

RESULTS

LVEF, TAPSE, St and FAC were significantly lower in the patient group. LV-LS 3-chamber, LV-GLS, RV-FWS, RV-GLS were significantly lower in the patient group.

CONCLUSIONS

RV-LS and LV-GLS were shown to decrease in the patient group. Although no obvious pathological values were observed in RV parameters on conventional echocardiography, TAPSE, St and FAC values were lower in the patient group.

摘要

背景

经胸超声心动图(TTE)是评估右心室(RV)功能的主要方法,但传统TTE参数的诊断价值有限,因为它们可能无法检测出RV收缩功能的早期异常。由于二维斑点追踪超声心动图(2D STE)能够检测心功能的亚临床损害,已被广泛用于研究RV功能。在本研究中,我们旨在调查肺部受累的COVID-19康复患者是否存在RV功能后遗症。

方法

这是一项对57名健康志愿者和54名患者进行的前瞻性观察队列研究。参与者无慢性疾病史,无呼吸或心脏症状的证据。这些患者因肺部受累的COVID-19住院,但不需要重症监护病房随访或无创机械通气支持。进行了TTE检查。收集了人口统计学和临床特征以及实验室检查结果。

结果

患者组的左心室射血分数(LVEF)、三尖瓣环平面收缩期位移(TAPSE)、心肌速度比值(St)和右心室面积变化分数(FAC)显著降低。患者组的左心室长轴应变(LV-LS)3腔、左心室整体纵向应变(LV-GLS)、右心室游离壁应变(RV-FWS)、右心室整体纵向应变(RV-GLS)显著降低。

结论

患者组显示右心室纵向应变(RV-LS)和左心室整体纵向应变(LV-GLS)降低。尽管常规超声心动图上RV参数未观察到明显的病理值,但患者组的TAPSE、St和FAC值较低。

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