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Echocardiography ph...
Echocardiography phenotypes of right ventricular involvement in COVID-19 ARDS patients and ICU mortality: post-hoc (exploratory) analysis of repeated data from the ECHO-COVID study
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- Huang, Stephen (author)
- Univ Sydney, Australia
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- Vieillard-Baron, Antoine (author)
- Univ Hosp Ambroise Pare, France; Univ Paris Saclay, France
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- Evrard, Bruno (author)
- Dupuytren Teaching Hosp, France
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- Prat, Gwenael (author)
- CHU Cavale Blanche Brest, France
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- Chew, Michelle S, 1969- (author)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
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- Balik, Martin (author)
- Charles Univ Prague, Czech Republic; Charles Univ Prague, Czech Republic
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- Clau-Terre, Fernando (author)
- Vall dHebron Univ Hosp, Spain
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- De Backer, Daniel (author)
- Univ Libre Bruxelles, Belgium
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- Dessap, Armand Mekontso (author)
- Univ Paris Est Creteil, France
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- Orde, Sam (author)
- Univ Sydney, Australia
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- Morelli, Andrea (author)
- Univ Rome, Italy
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- Sanfilippo, Filippo (author)
- Policlin Vittorio Emanuele Univ Hosp, Italy
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- Charron, Cyril (author)
- Univ Hosp Ambroise Pare, France; Univ Paris Saclay, France
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- Vignon, Philippe (author)
- Dupuytren Teaching Hosp, France; CHU Dupuytren, France
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(creator_code:org_t)
- SPRINGER, 2023
- 2023
- English.
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In: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. ; 49:8, s. 946-956
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- PurposeExploratory study to evaluate the association of different phenotypes of right ventricular (RV) involvement and mortality in the intensive care unit (ICU) in patients with acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19).MethodsPost-hoc analysis of longitudinal data from the multicenter ECHO-COVID observational study in ICU patients who underwent at least two echocardiography examinations. Echocardiography phenotypes were acute cor pulmonale (ACP, RV cavity dilatation with paradoxical septal motion), RV failure (RVF, RV cavity dilatation and systemic venous congestion), and RV dysfunction (tricuspid annular plane systolic excursion & LE; 16 mm). Accelerated failure time model and multistate model were used for analysis.ResultsOf 281 patients who underwent 948 echocardiography studies during ICU stay, 189 (67%) were found to have at least 1 type of RV involvements during one or several examinations: ACP (105/281, 37.4%), RVF (140/256, 54.7%) and/or RV dysfunction (74/255, 29%). Patients with all examinations displaying ACP had survival time shortened by 0.479 [0.284-0.803] times when compared to patients with all examinations depicting no ACP (P = 0.005). RVF showed a trend towards shortened survival time by a factor of 0.642 [0.405-1.018] (P = 0.059), whereas the impact of RV dysfunction on survival time was inconclusive (P = 0.451). Multistate analysis showed that patients might transit in and out of RV involvement, and those who exhibited ACP in their last critical care echocardiography (CCE) examination had the highest risk of mortality (hazard ratio (HR) 3.25 [2.38-4.45], P < 0.001).ConclusionRV involvement is prevalent in patients ventilated for COVID-19 ARDS. Different phenotypes of RV involvement might lead to different ICU mortality, with ACP having the worst outcome.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- COVID-19; ARDS; Right ventricular dysfunction; Cor pulmonale; Mortality
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Huang, Stephen
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Vieillard-Baron, ...
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Evrard, Bruno
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Prat, Gwenael
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Chew, Michelle S ...
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Balik, Martin
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Clau-Terre, Fern ...
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De Backer, Danie ...
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Dessap, Armand M ...
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Orde, Sam
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Morelli, Andrea
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Sanfilippo, Fili ...
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Charron, Cyril
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Vignon, Philippe
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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Intensive Care M ...
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Linköping University