: The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-CoV-2 pneumonia followed up for one year, 44 patients (mean age 58.4 ± 13.3, 70% males) without known cardiopulmonary disease were divided in two groups (PE+ and PE-, each comprising 22 patients) and underwent clinical and transthoracic echocardiographic examination, including right-ventricle global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RV-FWLS). While no significant differences were found in the left- or right-heart chambers' dimensions between the two study groups, the PE+ patients showed a significant reduction in RV-GLS (-16.4 ± 2.9 vs. -21.6 ± 4.3%, p < 0.001) and RV-FWLS (-18.9 ± 4 vs. -24.6 ± 5.12%, p < 0.001) values compared to the PE- patients. According to the ROC-curve analysis, RV-FWLS < 21% was the best cut-off with which to predict PE diagnosis in patients after SARS-CoV-2 pneumonia (sensitivity 74%, specificity 89%, area under the curve = 0.819, p < 0.001). According to the multivariate logistic regression model, RV-FWLS < 21% was independently associated with PE (HR 34.96, 95% CI:3.24-377.09, p = 0.003) and obesity (HR 10.34, 95% CI:1.05-101.68, p = 0.045). In conclusion, in recovered COVID-19 patients with a history of PE+, there is a persistence of subclinical RV dysfunction one year after the acute phase of the disease, detectable by a significant impairment in RV-GLS and RV-FWLS. A reduction in RV-FWLS of lower than 21% is independently associated with COVID-related PE.

Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism / Ilardi, Federica; Crisci, Mario; Calabrese, Cecilia; Scognamiglio, Anna; Arenga, Fortunato; Manzo, Rachele; Mariniello, Domenica F; Allocca, Valentino; Annunziata, Anna; D'Andrea, Antonello; Merenda, Raffaele; Monda, Vittorio; Esposito, Giovanni; Fiorentino, Giuseppe. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:11(2023), p. 3611. [10.3390/jcm12113611]

Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism

Ilardi, Federica;Calabrese, Cecilia;Manzo, Rachele;Esposito, Giovanni;
2023

Abstract

: The aim of this study was to investigate the presence of subclinical cardiac dysfunction in recovered coronavirus disease 2019 (COVID-19) patients, who were stratified according to a previous diagnosis of pulmonary embolism (PE) as a complication of COVID-19 pneumonia. Out of 68 patients with SARS-CoV-2 pneumonia followed up for one year, 44 patients (mean age 58.4 ± 13.3, 70% males) without known cardiopulmonary disease were divided in two groups (PE+ and PE-, each comprising 22 patients) and underwent clinical and transthoracic echocardiographic examination, including right-ventricle global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RV-FWLS). While no significant differences were found in the left- or right-heart chambers' dimensions between the two study groups, the PE+ patients showed a significant reduction in RV-GLS (-16.4 ± 2.9 vs. -21.6 ± 4.3%, p < 0.001) and RV-FWLS (-18.9 ± 4 vs. -24.6 ± 5.12%, p < 0.001) values compared to the PE- patients. According to the ROC-curve analysis, RV-FWLS < 21% was the best cut-off with which to predict PE diagnosis in patients after SARS-CoV-2 pneumonia (sensitivity 74%, specificity 89%, area under the curve = 0.819, p < 0.001). According to the multivariate logistic regression model, RV-FWLS < 21% was independently associated with PE (HR 34.96, 95% CI:3.24-377.09, p = 0.003) and obesity (HR 10.34, 95% CI:1.05-101.68, p = 0.045). In conclusion, in recovered COVID-19 patients with a history of PE+, there is a persistence of subclinical RV dysfunction one year after the acute phase of the disease, detectable by a significant impairment in RV-GLS and RV-FWLS. A reduction in RV-FWLS of lower than 21% is independently associated with COVID-related PE.
2023
Effects on Right Ventricular Function One Year after COVID-19-Related Pulmonary Embolism / Ilardi, Federica; Crisci, Mario; Calabrese, Cecilia; Scognamiglio, Anna; Arenga, Fortunato; Manzo, Rachele; Mariniello, Domenica F; Allocca, Valentino; Annunziata, Anna; D'Andrea, Antonello; Merenda, Raffaele; Monda, Vittorio; Esposito, Giovanni; Fiorentino, Giuseppe. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:11(2023), p. 3611. [10.3390/jcm12113611]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/936275
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