在重症监护室的COVID-19患者中,右心室功能障碍模式:回顾性队列分析
Pablo A Sanchez1, Christian T O'Donnell2, Nadia Francisco3
1Division of Cardiovascular Medicine.
Annals of the American Thoracic Society
|July 21, 2023
概括
右心室功能障碍在COVID-19患者中很常见,并且与死亡率增加有关. 多参数回声心电图的方法对于识别右心室功能障碍和改善患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 右心室 (RV) 功能障碍在住院的COVID-19患者中很普遍.
- 用于定义RV功能障碍的心声学参数可能会有所不同,这会影响流行病学评估.
- 了解COVID-19中的RV功能障碍对于患者管理和预后至关重要.
研究的目的:
- 为了确定RV功能异常的流行,使用COVID-19的ICU患者的常见心声学参数来确定RV功能异常的流行.
- 研究RV扩张对RV功能不同心声学参数的影响.
- 评估RV功能障碍与60天死亡率在这个患者队列之间的关联.
主要方法:
- 对116名COVID-19的ICU患者进行了回顾性队列研究.
- 心声图在 ICU 入院后的 7 天内进行.
- RV功能障碍和扩张定义为TAPSE的指导值,RV部分面积变化,RVFWS和RV维度;通过后勤回归评估死亡率.
主要成果:
- 69%的患者表现出至少一个参数的RV功能障碍;其中36.3%的患者有RV扩张.
- 常见的RV功能障碍模式包括多个异常,异常的RVFWS/TAPSE或孤立的TAPSE异常.
- RV功能障碍与60天死亡率 (OR 2.91) 的增加显著相关,特别是两个或更多参数异常.
结论:
- 在ICU COVID-19患者的RV功能异常中存在显著的异质性,与RV扩张相关的不同模式.
- 通过任何心声回声学参数识别的RV功能障碍与更高的死亡率有关.
- 多参数回声心动图评估对于准确识别COVID-19中RV功能障碍至关重要.
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