Background-Diastolic dysfunction is an independent predictor of mortality in patients with normal left ventricular ejection fraction. There are limited data, however, on whether worsening of diastolic function is associated with worse prognosis.

Coronavirus Disease 2019 (COVID-19) is a rapidly progressing global pandemic that may present with a variety of cardiac manifestations including, but not limited to, myocardial injury, myocardial infarction, arrhythmias, heart failure, cardiomyopathy, shock, thromboembolism, and cardiac arrest. These cardiovascular effects are worse in patients who have pre-existing cardiac conditions such as coronary artery disease, hypertension, diabetes mellitus, and coagulation abnormalities. Other predisposing risk factors include advanced age, immunocompromised state, and underlying systemic inflammatory conditions. Here we review the cellular pathophysiology, clinical manifestations and treatment modalities of the cardiac manifestations seen in patients with COVID-19.

Background Intravascular ultrasound ( IVUS ) guidance during percutaneous coronary intervention ( PCI ) offers tomographic images of the coronary vessels, allowing optimization of stent implantation at the time of PCI . However, the long‐term beneficial effect of IVUS over PCI guided by coronary angiography ( CA ) alone remains under question. We sought to investigate the outcomes of IVUS ‐guided compared with CA ‐guided PCI . Methods and Results We performed a comprehensive search of PubMed, Medline, and Cochrane Central Register, looking for randomized controlled trials and observational studies that compared PCI outcomes of IVUS with CA . Data were aggregated for the primary outcome measure using the random‐effects model as pooled risk ratio ( RR ). The primary outcomes were the rate of cardiovascular death, need for target lesion revascularization, occurrence of myocardial infarction, and rate of stent thrombosis. A total of 19 studies met the inclusion criteria, comprising 27 610 patients divided into IVUS (n=11 513) and CA (n=16 097). Compared with standard CA ‐guided PCI , we found that the risks of cardiovascular death ( RR , 0.63; 95% CI , 0.54–0.73), myocardial infarction ( RR , 0.71; 95% CI , 0.58–0.86), target lesion revascularization ( RR , 0.81; 95% CI , 0.70–0.94), and stent thrombosis ( RR , 0.57; 95% CI , 0.41–0.79) were all significantly lower using IVUS guidance. Conclusions Compared with standard CA ‐guided PCI , the use of IVUS imaging guidance to optimize stent implantation is associated with a reduced risk of cardiovascular death and major adverse events, such as myocardial infarction, target lesion revascularization, and stent thrombosis.