Rouzrokh Parsa, Rezaee Malihe, Mohammadipour Zahra, Tavana Sasan, Khaheshi Isa, Sheikhy Ali, Faghihi Langroudi Taraneh
Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran.
Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2024;16(3):171-178. doi: 10.34172/jcvtr.33094. Epub 2024 Sep 20.
It has been demonstrated that an increase in the diameter of the right ventricle or pulmonary artery in COVID-19 patients could be associated with the severity of lung involvement and may lead to unfavorable outcomes, particularly in the presence of pulmonary vascular diseases. This study investigated the relationship between these right heart strain features, the extent of lung involvement, and their prognostic values in patients without vascular comorbidities.
This study selected 154 consecutive patients with positive chest computed tomography (CT) findings and no evidence of concurrent pulmonary disease. Clinical characteristics and adverse outcomes in in-hospital settings were collected retrospectively. Diameters of cardiac ventricles and arteries, along with lung opacification scores, were obtained using CT pulmonary angiography (CTPA) findings, and the association of these variables was evaluated.
An increase in pulmonary artery (PA) to ascending aorta (AO) diameter ratio and lung parenchymal damage were significantly and positively correlated (=0.017), but increased right ventricle (RV) to left ventricle (LV) diameter ratio showed no association with the extent of chest opacification (=0.098). Evaluating the prognostic ability of both ratios using logistic regression and receiver operating characteristic (ROC) analysis proved no significant class separation in regards to predicting adverse outcomes (PA/AO: OR:1.081, Value:0.638, RV/LV: OR:1.098, Value:0.344).
In COVID-19 patients without vascular comorbidities, a higher PA/AO diameter ratio was significantly associated with increased lung involvement severity on CT imaging but not with adverse in-hospital outcomes. Conversely, an increased RV/LV ratio on CTPA did not correlate significantly with adverse outcomes or the severity of parenchymal lung damage.
已有研究表明，新型冠状病毒肺炎（COVID-19）患者右心室或肺动脉直径增加可能与肺部受累的严重程度相关，并可能导致不良预后，尤其是在存在肺血管疾病的情况下。本研究调查了这些右心应变特征、肺部受累程度及其在无血管合并症患者中的预后价值之间的关系。
本研究选取了154例胸部计算机断层扫描（CT）结果阳性且无并发肺部疾病证据的连续患者。回顾性收集住院期间的临床特征和不良结局。使用CT肺动脉造影（CTPA）结果获得心室和动脉直径以及肺实变评分，并评估这些变量之间的关联。
肺动脉（PA）与升主动脉（AO）直径比增加与肺实质损伤显著正相关（=0.017），但右心室（RV）与左心室（LV）直径比增加与胸部实变程度无关（=0.098）。使用逻辑回归和受试者工作特征（ROC）分析评估这两个比值的预后能力，结果表明在预测不良结局方面没有显著的类别区分（PA/AO：比值比：1.081， 值：0.638，RV/LV：比值比：1.098， 值：0.344）。
在无血管合并症的COVID-19患者中，较高的PA/AO直径比与CT成像上肺部受累严重程度增加显著相关，但与住院期间的不良结局无关。相反，CTPA上RV/LV比值增加与不良结局或肺实质损伤严重程度无显著相关性。
