Open AccessEchocardiographic abnormalities and predictors of mortality in hospitalized COVID‐19 patients: the ECHOVID‐19 study
Author(s) -
Lassen Mats Christian Højbjerg,
Skaarup Kristoffer Grundtvig,
Lind Jannie Nørgaard,
Alhakak Alia Saed,
Sengeløv Morten,
Nielsen Anne Bjerg,
Espersen Caroline,
Ravnkilde Kirstine,
Hauser Raphael,
Schöps Liv Borum,
Holt Eva,
Johansen Niklas Dyrby,
Modin Daniel,
Djernæs Kasper,
Graff Claus,
Bundgaard Henning,
Hassager Christian,
Jabbari Reza,
Carlsen Jørn,
Lebech AnneMette,
Kirk Ole,
Bodtger Uffe,
Lindholm Matias Greve,
Joseph Gowsini,
Wiese Lothar,
Schiødt Frank Vinholt,
Kristiansen Ole Peter,
Walsted Emil Schwarz,
Nielsen Olav Wendelboe,
Madsen Birgitte Lindegaard,
Tønder Niels,
Benfield Thomas,
Jeschke Klaus Nielsen,
Ulrik Charlotte Suppli,
Knop Filip Krag,
Lamberts Morten,
Sivapalan Pradeesh,
Gislason Gunnar,
Marott Jacob Louis,
Møgelvang Rasmus,
Jensen Gorm,
Schnohr Peter,
Søgaard Peter,
Solomon Scott D.,
Iversen Kasper,
Jensen Jens Ulrik Stæhr,
Schou Morten,
BieringSørensen Tor
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13044
Subject(s) - medicine , hazard ratio , confidence interval , cardiology , proportional hazards model , prospective cohort study , covid-19 , population , heart failure , disease , environmental health , infectious disease (medical specialty)
Aims The present study had two aims: (i) compare echocardiographic parameters in COVID‐19 patients with matched controls and (2) assess the prognostic value of measures of left (LV) and right ventricular (RV) function in relation to COVID‐19 related death. Methods and results In this prospective multicentre cohort study, 214 consecutive hospitalized COVID‐19 patients underwent an echocardiographic examination (by pre‐determined research protocol). All participants were successfully matched 1:1 with controls from the general population on age, sex, and hypertension. Mean age of the study sample was 69 years, and 55% were male participants. LV and RV systolic function was significantly reduced in COVID‐19 cases as assessed by global longitudinal strain (GLS) (16.4% ± 4.3 vs. 18.5% ± 3.0, P < 0.001), tricuspid annular plane systolic excursion (TAPSE) (2.0 ± 0.4 vs. 2.6 ± 0.5, P < 0.001), and RV strain (19.8 ± 5.9 vs. 24.2 ± 6.5, P = 0.004). All parameters remained significantly reduced after adjusting for important cardiac risk factors. During follow‐up (median: 40 days), 25 COVID‐19 cases died. In multivariable Cox regression reduced TAPSE [hazard ratio (HR) = 1.18, 95% confidence interval (CI) [1.07–1.31], P = 0.002, per 1 mm decrease], RV strain (HR = 1.64, 95%CI[1.02;2.66], P = 0.043, per 1% decrease) and GLS (HR = 1.20, 95%CI[1.07–1.35], P = 0.002, per 1% decrease) were significantly associated with COVID‐19‐related death. TAPSE and GLS remained significantly associated with the outcome after restricting the analysis to patients without prevalent heart disease. Conclusions RV and LV function are significantly impaired in hospitalized COVID‐19 patients compared with matched controls. Furthermore, reduced TAPSE and GLS are independently associated with COVID‐19‐related death.