Article ; Online: Usefulness of Right Ventricular Longitudinal Shortening Fraction to Detect Right Ventricular Dysfunction in Acute Cor Pulmonale Related to COVID-19.
Journal of cardiothoracic and vascular anesthesia
2021 Volume 35, Issue 12, Page(s) 3594–3603
Abstract: ... with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (CARDS) complicated or not ... by acute cor pulmonale (ACP).: Design: Prospective, between March 1, 2020 and April 15, 2020.: Setting ... longitudinal shortening fraction [RV-LSF]), RV global longitudinal strain (RV-GLS), and RV free wall ...
| Abstract | Objective: To compare two-dimensional-speckle tracking echocardiographic parameters (2D-STE) and classic echocardiographic parameters of right ventricular (RV) systolic function in patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (CARDS) complicated or not by acute cor pulmonale (ACP). Design: Prospective, between March 1, 2020 and April 15, 2020. Setting: Intensive care unit of Amiens University Hospital (France). Participants: Adult patients with moderate-to-severe CARDS under mechanical ventilation for fewer than 24 hours. Interventions: None. Measurements and main results: Tricuspid annular displacement (TAD) parameters (TAD-septal, TAD-lateral, and RV longitudinal shortening fraction [RV-LSF]), RV global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RVFWLS) were measured using transesophageal echocardiography with a dedicated software and compared with classic RV systolic parameters (RV-FAC, S' wave, and tricuspid annular plane systolic excursion [TAPSE]). RV systolic dysfunction was defined as RV-FAC <35%. Twenty-nine consecutive patients with moderate-to-severe CARDS were included. ACP was diagnosed in 12 patients (41%). 2D-STE parameters were markedly altered in the ACP group, and no significant difference was found between patients with and without ACP for classic RV parameters (RV-FAC, S' wave, and TAPSE). In the ACP group, RV-LSF (17% [14%-22%]) had the best correlation with RV-FAC (r = 0.79, p < 0.001 v r = 0.27, p = 0.39 for RVGLS and r = 0.28, p = 0.39 for RVFWLS). A RV-LSF cut-off value of 17% had a sensitivity of 80% and a specificity of 86% to identify RV systolic dysfunction. Conclusions: Classic RV function parameters were not altered by ACP in patients with CARDS, contrary to 2D-STE parameters. RV-LSF seems to be a valuable parameter to detect early RV systolic dysfunction in CARDS patients with ACP. |
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| MeSH term(s) | Adult ; COVID-19 ; Humans ; Prospective Studies ; Pulmonary Heart Disease/diagnostic imaging ; Pulmonary Heart Disease/etiology ; SARS-CoV-2 ; Ventricular Dysfunction, Right/diagnostic imaging ; Ventricular Dysfunction, Right/etiology ; Ventricular Function, Right | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-01-18 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Journal Article | ||||||||||
| ZDB-ID | 1067317-9 | ||||||||||
| ISSN | 1532-8422 ; 1053-0770 | ||||||||||
| ISSN (online) | 1532-8422 | ||||||||||
| ISSN | 1053-0770 | ||||||||||
| DOI | 10.1053/j.jvca.2021.01.025 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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