Cardiac Muscle Injury and Echocardiographic Plus Electrocardiographic Findings in Patients With 2019 Novel
Mostafa Abohelwa1, Ahmed A Mohamed2, Gaspar Del-Rio-Pertuz3
1Cardiovascular Division, Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.
Insights
Myocardial injury in coronavirus-2019 (COVID-19) patients is linked to higher mortality. Clinical factors like age and acute respiratory distress syndrome, not echocardiography or ECG findings, significantly predicted death in COVID-19 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Myocardial injury is a recognized complication of coronavirus-2019 (COVID-19).
- Limited data exists on cardiovascular imaging (echocardiography, ECG) in COVID-19 patients and its relation to mortality.
- This study investigates the association between myocardial injury and mortality in hospitalized COVID-19 patients.
Purpose of the Study:
- To evaluate the correlation between myocardial injury and mortality in COVID-19 patients.
- To identify clinical and cardiovascular imaging predictors of mortality in COVID-19.
Main Methods:
- Retrospective cohort study of 438 COVID-19 patients admitted between March 2020 and February 2021.
- Myocardial injury defined by elevated high-sensitivity troponin T (> 20 ng/L).
- Bivariate and multivariate logistic regression analyses were used to assess mortality predictors.
Main Results:
- A total of 260 patients (59.4%) experienced myocardial injury.
- Patients with myocardial injury exhibited significantly higher mortality rates (P < 0.05).
- Mortality was significantly associated with age, race/ethnicity, acute respiratory distress syndrome, shock, vasopressors, mechanical ventilation, and hemodialysis.
Conclusions:
- Myocardial injury in COVID-19 patients is associated with increased mortality.
- Clinical factors, not transthoracic echocardiography or electrocardiography findings, were significant predictors of mortality.
- This highlights the importance of monitoring clinical variables in COVID-19 patients with myocardial injury.
Background:
Myocardial injury has been described in coronavirus-2019 (COVID-19). Few studies have reported cardiovascular imaging data with transthoracic echocardiography (TTE) and electrocardiography (ECG) findings in COVID-19 patients, and their correlation with mortality.
Methods:
We conducted a retrospective cohort study that included COVID-19 patients from March 2020 through February 2021 who had TTE and ECG during hospital admission. Myocardial injury was defined by an elevated high-sensitivity troponin T level > 20 ng/L. Bivariate analysis was used to compare patients with myocardial injury and those without. Multivariate logistic regression analysis was performed to identify the variables associated with mortality.
Results:
A total of 438 patients were included. The mean age was 62.1 ± 14.9 years, and 58.9% were male. A total of 149 patients died, with a mortality rate of 34%. A total of 260 patients (59.4%) had myocardial injury. The average left ventricular ejection fraction was 59.8% ± 11.2%, with 30 patients (6.8%) having an ejection fraction of < 40%. Patients with myocardial injury had higher mortality than those without (P < 0.05, χ2 test). A multiple regression analysis model indicated that age, race and/or ethnicity, the development of acute respiratory distress syndrome, shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the variables significantly associated with mortality.
Conclusion:
COVID-19 patients with myocardial injury had higher mortality than those without. Age, race and/or ethnicity, acute respiratory distress syndrome, shock, the need for vasopressors, mechanical ventilation, and hemodialysis were the clinical variables associated with mortality. The TEE and ECG variables studied were not significantly associated with mortality.
More Related Videos
Related Concept Videos
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...