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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Hyperdynamic left ventricular ejection fraction is associated with higher mortality in COVID-19 patients

Annas Rahman1, Max Ruge2, Alex Hlepas1

  • 1Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America.

American Heart Journal Plus : Cardiology Research and Practice
|April 25, 2022
PubMed

Insights

Patients hospitalized with COVID-19 and hyperdynamic left ventricular ejection fraction (HDLVEF) faced higher 60-day mortality risks. This study highlights HDLVEF as a critical indicator for severe COVID-19 outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • COVID-19 can significantly impact cardiac function.
  • Left ventricular ejection fraction (LVEF) is a key measure of heart function.
  • Understanding LVEF variations in COVID-19 patients is crucial for prognostication.

Purpose of the Study:

  • To compare characteristics and outcomes of COVID-19 patients with hyperdynamic LVEF (HDLVEF) against those with normal or reduced LVEF.
  • To assess LVEF as a predictor of 60-day mortality in hospitalized COVID-19 patients.

Main Methods:

  • Retrospective study including 419 adult COVID-19 patients with transthoracic echocardiograms.
  • Patients categorized into reduced (<50%), normal (≥50% to <70%), and hyperdynamic (≥70%) LVEF groups.
  • Logistic regression analysis adjusted for age and BMI to evaluate 60-day mortality.

Main Results:

  • No significant difference in 60-day mortality between reduced and normal LVEF groups.
  • HDLVEF group showed significantly higher 60-day mortality compared to the normal LVEF group (aOR 2.63).
  • HDLVEF group also had higher 60-day mortality risk compared to the reduced LVEF group (aOR 3.34).

Conclusions:

  • Hyperdynamic LVEF in COVID-19 patients is associated with increased 60-day mortality.
  • HDLVEF is linked to higher requirements for mechanical ventilation, vasopressors, and ICU admission.
  • LVEF assessment can aid in identifying high-risk COVID-19 patients.
Abstract

Keywords:
COVID-19COVID-19, coronavirus disease 2019HFpEF, heart failure with preserved ejection fractionHFrEF, heart failure with reduced ejection fractionHeart failureHyperdynamicICU, intensive care unitLVEF, left ventricular ejection fractionLeft ventricular ejection fractionMACE, major adverse cardiovascular eventsNLVEF, normal left ventricular ejection fractionRLVEF, reduced left ventricular ejection fractionSARS-CoV-2TTE, transthoracic echocardiogram

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