Funding Acknowledgements Type of funding sources: None. Background COVID-19 infection may cause acute respiratory distress syndrome (ARDS). Severe COVID-19 infection may develop a right ventricle dysfunction due to several mechanism. As we know, the right ventricle dysfunction may lead to poor outcome. Purpose To study the correlation of right ventricle function, evaluated by tricuspid annular plane systolic excursion (TAPSE) with mortality in ARDS COVID-19. Methods This is a correlation study with retrospective design. Data were collected from COVID-19 registry. Results Ninety-four ARDS COVID-19 patients were enrolled in this study. The mean age was 60.5 ± 11.6 years old. Thirty-one of them were female (33%). Patient with cardiovascular morbidity was 86.2%. Patient with congestive heart failure was 57.4%, stable coronary artery disease was 47.8%, hypertension was 69.1%, smoker was 13.8%, atrial fibrillation was 13.8%, acute coronary syndrome was 16% and diabetes mellitus was 51.1%. The ROC analysis showed AUC 0.743 (74.3%) with a TAPSE cut off was 18.5 mm with sensitivity 70.4% and specificity 64.2%. Multivariate analysis showed an association between TAPSE and mortality, p 0.021 (OR 4.772;95% CI 1.27-17.93). There was no correlation between TAPSE and ARDS severity, p 0.456. Conclusion This study demonstrated there was an association between right ventricle function (TAPSE) and inhospital mortality in ARDS COVID-19.
BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with highly heterogenous clinical presentation involving, e.g., skin, joints, kidneys and the cardiovascular system. In prospective studies, the incidence rates of myocardial infarction and stroke in patients with SLE have been shown to be high, but more knowledge is needed regarding early myocardial involvement and affection of the right ventricle in different SLE phenotypes.ObjectivesThe aim of the present study was to investigate differences of left- and right ventricular systolic function in three, well-defined SLE phenotypes, i.e. skin- and joint involvement, lupus nephritis antiphospholipid syndrome (APS), respectively.MethodsTransthoracic echocardiograms were performed in 60 subjects with SLE (three age- and sex-matched groups of subjects with either skin- and joint involvement, lupus nephritis or APS, respectively) included in the SLEVASK [1] cohort which represents a subgroup of the regional quality registerClinical Lupus Register in North-Eastern Gothia(Swedish acronym: KLURING). There were 54 women and 6 men, and the median age was 48.5 (range 28-68y) years. Left- and right ventricular dimensions and standard systolic function parameters were measured according to international guidelines. Left and right ventricular longitudinal strain and left ventricular mechanical dispersion, defined as the standard deviation of time to maximal myocardial shortening were measured by a commercially available software. Three subjects with clinically manifest heart failure were excluded.ResultsThere were no significant differences in left- or right ventricular dimensions, left ventricular ejection fraction or measures of right ventricular systolic function between the three groups. Left ventricular global longitudinal strain was reduced in subjects with nephritis (p=0.012), as compared to those with skin- and joint involvement and there was a trend for lower strain also among subjects with APS (p=0.078). Left ventricular mechanical dispersion was increased among subjects with APS (p=0.015) and nephritis (p=0.032), as compared to those with skin- and joint involvement (Table 1).ConclusionReduced left ventricular global longitudinal strain and greater mechanical dispersion, a sign of a more heterogonous contraction, among SLE patients with nephritis and APS indicate more severe cardiac involvement, as compared to those with skin- and joint involvement. A greater degree of mechanical dispersion is thought to reflect myocardial fibrosis and future studies should investigate the pathogenesis of such sub-clinical impairment of cardiac function in SLE and its impact on long-term prognosis.Reference[1]Svensson C, Eriksson P, Zachrisson H, Sjöwall C. High-Frequency Ultrasound of Multiple Arterial Areas Reveals Increased Intima Media Thickness, Vessel Wall Appearance, and Atherosclerotic Plaques in Systemic Lupus Erythematosus.Front Med (Lausanne) 2020;7:581336Table 1.Lupus nephritisAPSJoint- and skin involvementp-valueLVEDDI (mm/m2)26 (25-28)26 (24-27)27 (26-28)p=nsLVEDVI (ml/m2)58 (46-65)53 (55-62)57 (49-67)p=nsLVEF (%)57 (56-59)57 (55-59)58 (56-61)p=nsLV-GLS (%)-20 (-21--18)-20 (-21--19)-21 (-23--20)p=0.030LVMD (ms)38 (31-46)38 (32-50)32 (27-35)p=0.037RVOTD (mm)32 (27-34)31 (27-36)28 (26-31)p=nsRVITD (mm)35 (31-36)36 (31-38)33 (31-37)p=nsTAPSE (mm)23 (20-25)22 (20-25)22 (21-25)p=nsRV s’ (cm/s)13 (11-16)13 (11-15)15 (12-16)p=nsRV-GLS (%)-22 (-24--20)-21 (-23--19)-23 (-24--21)p=nsRV-FWS (%)-26 (-27--24)-25 (-27--23)-26 (-30--24)p=nsValues are median with interquartile range (IQR). Abbreviations: LVEDDI = left ventricular end-diastolic diameter index; LVEDVI = left ventricular end-diastolic volume index; LVEF = left ventricular ejection fraction; LV-GLS = left ventricular global longitudinal stain; LVMD = left ventricular mechanical dispersion; ns = not significant; RVOT = Right ventricular outflow tract diameter; RVITD = Right ventricular inflow tract diameter; TAPSE = tricuspid annular plane systolicAcknowledgements:NIL.Disclosure of InterestsNone Declared.
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