在COVID-19相关的肺栓塞发生一年后,对右心室功能的影响
Federica Ilardi1, Mario Crisci2, Cecilia Calabrese3
1Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini, 5, 80131 Naples, Italy.
Journal of clinical medicine
|June 10, 2023
概括
肺栓塞 (PE) 病史的康复COVID-19患者在感染后一年内表现出持续的亚临床右心室 (RV) 功能障碍. 损伤的RV自由壁纵向拉伸 (RV-FWLS) 低于21%是这种功能障碍的关键指标,与PE相关.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 冠状病毒疾病2019 (COVID-19) 可能导致肺栓塞 (PE),这是一个严重的并发症.
- COVID-19的长期心脏影响,特别是亚临床功能障碍,需要进一步调查.
研究的目的:
- 在康复的COVID-19患者中评估亚临床心脏功能障碍,有或没有PE病史.
- 在COVID-19后的患者中确定可预测PE的心声学标志物.
主要方法:
- 在44名康复的COVID-19患者 (22名有PE,22名没有PE) 上进行了跨胸腔心声扫描.
- 测量包括右心室全球纵向应变 (RV-GLS) 和RV自由壁纵向应变 (RV-FWLS).
- 统计分析,包括ROC曲线和多变量后勤回归,用于确定PE的预测因素.
主要成果:
- 与没有PE (PE-) 的患者相比,患有PE (PE+) 的患者表现出显著减少的RV-GLS和RV-FWLS.
- 确定RV-FWLS<21%是预测PE的最佳切断值 (灵敏度74%,特异性89%).
- 减少RV-FWLS (<21%) 在这个队列中独立与PE和肥胖有关.
结论:
- 亚临床右心室功能障碍在COVID-19后的一年内,在有PE病史的患者中持续存在.
- 损坏的RV-GLS和RV-FWLS是这种持续性功能障碍的关键指标.
- RV-FWLS <21%是COVID相关PE的显著独立预测因素.
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