Gefen Sheizaf, Shetrit Aviel, Ghantous Eihab, Hochstadt Aviram, Lupu Lior, Banai Ariel, Levi Erez, Szekely Yishay, Zahler David, Schellekes Nadav, Jacoby Tammy, Itach Tamar, Taieb Philippe, Shidlansik Lia, Viskin Dana, Adler Amos, Levitsky Ekaterina, Ingbir Merav, Havakuk Ofer, Banai Shmuel, Topilsky Yan
Department of Cardiology, Tel Aviv Medical Center and School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
CJC Open. 2024 Sep 25;6(12):1513-1520. doi: 10.1016/j.cjco.2024.09.006. eCollection 2024 Dec.
Information about left atrial (LA) 2-dimensional (2D) strain parameters in patients with the Omicron variant of COVID-19 is limited. The aim of this study is to evaluate LA strain (LAS) in COVID-19 patients with the Omicron variant and compare it to that of propensity-matched patients with the wild-type (WT) variant.
A total of 148 consecutive patients who were hospitalized with Omicron COVID-19 underwent an echocardiographic evaluation within the first day after hospital admission and were compared to propensity-matched patients (1:1) with the WT variant. LA 2D speckle tracking echocardiography parameters included the following: LAS, reservoir (LASr); LAS, conduit (LAScd); LAS, contraction (LASct); and LASr to the ratio between early mitral inflow velocity/mitral annular early diastolic velocity (E/e'). The values for the parameters that occurred during acute Omicron-type infection were compared with those found on historic examinations in 36 patients.
Compared to the matched WT cohort, patients with acute Omicron-type infection had similar LASr (31.3% ± 13.3% vs 33.0% ± 14.2%), LAScd (-18.7% ± 9.8% vs -18.6% ± 10.8%), and LASct (-12.5% ± 8.6% vs -13.6% ± 8.2%) values ( > 0.2 for all), but a higher E/e' ratio (11.8 ± 6 vs 10.1 ± 7; = 0.03). Surprisingly, LASr (31.9% ± 13.7% vs 22.6% ± 13.9%; = 0.04) and LAScd (-18.7% ± 9.7% vs -10.7% ± 6.6%; < 0.001) improved in patients during acute infection. LASr, LAScd, and LASr/(E/e') were significantly associated with an increased risk of either in-hospital mortality, need for mechanical ventilation, or the combined event.
In hospitalized patients with an Omicron COVID-19 infection, LAS parameters are similar to those of matched patients with WT variant and are associated with mortality and respiratory deterioration. These abnormalities were recorded previously in the 36 patients with historical echocardiograms, suggesting that they are related to background cardiac disease.
关于新冠病毒奥密克戎变异株患者左心房（LA）二维（2D）应变参数的信息有限。本研究的目的是评估感染奥密克戎变异株的新冠患者的左心房应变（LAS），并将其与倾向匹配的野生型（WT）变异株患者进行比较。
共有148例因奥密克戎新冠感染住院的连续患者在入院后第一天接受了超声心动图评估，并与倾向匹配的WT变异株患者（1:1）进行比较。LA二维斑点追踪超声心动图参数包括：LAS，储存期（LASr）；LAS，传导期（LAScd）；LAS，收缩期（LASct）；以及LASr与二尖瓣早期血流速度/二尖瓣环舒张早期速度之比（E/e'）。将急性奥密克戎型感染期间出现的参数值与36例患者历史检查中发现的值进行比较。
与匹配的WT队列相比，急性奥密克戎型感染患者的LASr（31.3%±13.3%对33.0%±14.2%）、LAScd（-18.7%±9.8%对-18.6%±10.8%）和LASct（-12.5%±8.6%对-13.6%±8.2%）值相似（所有P>0.2），但E/e'比值更高（11.8±6对10.1±7；P=0.03）。令人惊讶的是，急性感染期间患者的LASr（31.9%±13.7%对22.6%±13.9%；P=0.04）和LAScd（-18.7%±9.7%对-10.7%±6.6%；P<0.001）有所改善。LASr、LAScd和LASr/（E/e'）与住院死亡率增加、需要机械通气或联合事件的风险显著相关。
在感染奥密克戎新冠的住院患者中，LAS参数与匹配的WT变异株患者相似，且与死亡率和呼吸功能恶化相关。这些异常在36例有历史超声心动图的患者中也曾记录到，表明它们与基础心脏病有关。
