Open AccessRight heart condition in patients with COVID-19 pneumonia
Author(s) -
Н. Г. Потешкина,
Н. С. Крылова,
A. A. Karasev,
Т. А. Никитина,
А. М. Сванадзе,
Irina P. Beloglazova,
E. A. Kovalevskaya,
K. A. Barakhanov,
М. А. Лысенко,
A. M. Ibragimova,
В. Н. Сморщок
Publication year - 2021
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2021-4733
Subject(s) - medicine , pneumonia , ventricle , natriuretic peptide , cardiology , c reactive protein , pneumonia severity index , brain natriuretic peptide , covid-19 , procalcitonin , parenchyma , gastroenterology , lung , community acquired pneumonia , pathology , heart failure , inflammation , disease , sepsis , infectious disease (medical specialty)
Aim . To assess right heart condition in patients with coronavirus disease 2019 (COVID-19) pneumonia. Material and methods . One hundred and five patients with COVID-19 pneumonia were divided into 3 groups depending on the involvement of lung parenchyma: group I — 0-25%, II — 25-50%, III — 50-75%. The clinical status of patients was assessed using the NEWS2 and SHOKS-COVID scales. A complete blood count and biochemical blood tests were performed to determine the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin I. Echocardiography was performed to assess the right heart structural, hemodynamic and functional parameters. Results . In patients with COVID-19 pneumonia, with an increase in lung parenchyma involvement, the intensity of systemic inflammatory response increased: C-reactive protein, group I — (4 [1,9; 35] mg/l), in III — (70,5 [33; 144] mg/l) (pI-III=0,012); myocardial stress marker level increased: NT-proBNP, group I — 77 [48; 150] ng/l, group III — 165 [100; 287] ng/l (p I-III =0,047). The dependence of NT-proBNP on C-reactive protein level was revealed (r=0,335, p=0,03). Intergroup comparison did not reveal significant differences between the main right heart functional parameters: TAPSE, Tei index (PW and TDI), FAC of the right ventricle (RV) (p>0,05). However, differences in the tricuspid annular peaks were found as follows: group I — 0,14 [0,12; 0,14] m/s, group II — 0,14 [0,12; 0,15] m/s, group III — 0,16 [0,14; 0,17] m/s (p I-II =0,012, p I-III =0,014) and RV global longitudinal strain: group I — 19,63±7,72%, group III — 27,4±5,93% (p I-III =0,014). The relationship between the RV global longitudinal strain and SHOKS-COVID score was confirmed (r=0,381; p=0,024). Conclusion . Patients with COVID-19 pneumonia showed no signs of right heart dysfunction. The development of RV hyperfunction was noted. Most likely, this is a compensatory mechanism in response to acute RV afterload. NT-proBNP increase under conditions of an inflammatory response may indicate myocardial stress. The results obtained allow to expand our understanding of the right heart condition in patients with COVID-19 pneumonia.