Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19
Aim. To determine the predictive role of estimated pulmonary artery systolic pressure (ePASP) in COVID-19 patients.Material and methods. A retrospective study of inpatients with documented COVID-19 infection was carried out. Maximal follow-up period was 63 days. The study included 108 patients (men,...
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«FIRMA «SILICEA» LLC
2020-12-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4136 |
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| author | E. Z. Golukhova Inessa Viktorovna Slivneva M. M. Rybka M. L. Mamalyga M. N. Alekhin I. V. Klyuchnikov D. E. Antonova D. I. Marapov |
| author_facet | E. Z. Golukhova Inessa Viktorovna Slivneva M. M. Rybka M. L. Mamalyga M. N. Alekhin I. V. Klyuchnikov D. E. Antonova D. I. Marapov |
| author_sort | E. Z. Golukhova |
| collection | DOAJ |
| description | Aim. To determine the predictive role of estimated pulmonary artery systolic pressure (ePASP) in COVID-19 patients.Material and methods. A retrospective study of inpatients with documented COVID-19 infection was carried out. Maximal follow-up period was 63 days. The study included 108 patients (men, 62; women, 46; mean age, 62,9±15,5 years). At admission, mean NEWS score was 6,0, blood oxygen saturation — 92%. Echocardiography was performed according to standard protocol using Vivid E9 ultrasound system (GE Healthcare). Quantitative measurements were performed according to the current ASE and EACVI guidelines. Statistical analysis was performed using the IBM SPSS Statistics v.26 software (developed by IBM Corporation).Results. Using the CHAID technique, a classification tree was developed and the strongest predictor of an unfavorable outcome was determined (ePASP). Threshold ePASP values, associated with an increased mortality risk were established (42 mm Hg and 50 mm Hg). Three groups of patients were selected based on the main predictor (<41,0 mm Hg, 42-49 mm Hg and >50 mm Hg). The increased mortality risk was noted in groups 2 and 3 compared to group 1 of patients and amounted to 31,8% and 70% versus 3,9%, respectively. There was also a correlation between the severity of CT lung parenchymal lesions according to computed tomography and the study groups of patients (36% [30-49%] — group 1, 50% [36-76%] — group 2, and 84% [56-92%] — group 3, p=0,001). In groups 2 and 3, the following complications were significantly more frequent: acute respiratory distress syndrome, acute heart failure, multiple organ system failure, venous thrombosis, disseminated intravascular coagulation. In group 3, acute renal failure and systemic inflammatory response syndrome developed significantly more often than in group 1.Conclusion. A comprehensive echocardiography has proven its availability and safety in assessing the condition of COVID-19 patients, allowing to obtain relevant information on pulmonary hemodynamics. Transthoracic echocardiography reduced the risk of complications from invasive diagnostic methods and allowed to abandon the use of the Swan-Ganz pulmonary artery catheter in the studied group of patients. As a result, a relationship was noted between the increase of ePASP and the severity of clinical performance and lung tissue damage according to computed tomography, changes in laboratory blood tests, the severity of the comorbid profile, an increase in respiratory support need. |
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| issn | 1560-4071 2618-7620 |
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| series | Российский кардиологический журнал |
| spelling | doaj.art-9aa5d608a4c548f3a0393e3ab67c48502025-03-02T11:42:53Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202020-12-01251210.15829/1560-4071-2020-41363095Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19E. Z. Golukhova0Inessa Viktorovna Slivneva1M. M. Rybka2M. L. Mamalyga3M. N. Alekhin4I. V. Klyuchnikov5D. E. Antonova6D. I. Marapov7Bakulev National Medical Research Center of Cardiovascular SurgeryA.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian FederationA.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian FederationA.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian FederationCentral Clinical Hospital, Central State Medical Academy of the Presidential Administration of the Russian FederationA.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian FederationA.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian FederationEducational and methodical center "Lean Technologies in Healthcare", Kazan State Medical UniversityAim. To determine the predictive role of estimated pulmonary artery systolic pressure (ePASP) in COVID-19 patients.Material and methods. A retrospective study of inpatients with documented COVID-19 infection was carried out. Maximal follow-up period was 63 days. The study included 108 patients (men, 62; women, 46; mean age, 62,9±15,5 years). At admission, mean NEWS score was 6,0, blood oxygen saturation — 92%. Echocardiography was performed according to standard protocol using Vivid E9 ultrasound system (GE Healthcare). Quantitative measurements were performed according to the current ASE and EACVI guidelines. Statistical analysis was performed using the IBM SPSS Statistics v.26 software (developed by IBM Corporation).Results. Using the CHAID technique, a classification tree was developed and the strongest predictor of an unfavorable outcome was determined (ePASP). Threshold ePASP values, associated with an increased mortality risk were established (42 mm Hg and 50 mm Hg). Three groups of patients were selected based on the main predictor (<41,0 mm Hg, 42-49 mm Hg and >50 mm Hg). The increased mortality risk was noted in groups 2 and 3 compared to group 1 of patients and amounted to 31,8% and 70% versus 3,9%, respectively. There was also a correlation between the severity of CT lung parenchymal lesions according to computed tomography and the study groups of patients (36% [30-49%] — group 1, 50% [36-76%] — group 2, and 84% [56-92%] — group 3, p=0,001). In groups 2 and 3, the following complications were significantly more frequent: acute respiratory distress syndrome, acute heart failure, multiple organ system failure, venous thrombosis, disseminated intravascular coagulation. In group 3, acute renal failure and systemic inflammatory response syndrome developed significantly more often than in group 1.Conclusion. A comprehensive echocardiography has proven its availability and safety in assessing the condition of COVID-19 patients, allowing to obtain relevant information on pulmonary hemodynamics. Transthoracic echocardiography reduced the risk of complications from invasive diagnostic methods and allowed to abandon the use of the Swan-Ganz pulmonary artery catheter in the studied group of patients. As a result, a relationship was noted between the increase of ePASP and the severity of clinical performance and lung tissue damage according to computed tomography, changes in laboratory blood tests, the severity of the comorbid profile, an increase in respiratory support need.https://russjcardiol.elpub.ru/jour/article/view/4136transthoracic echocardiographyechocardiographyestimated pulmonary artery systolic pressurecovid-19predictor of unfavorable outcomeprognostic modelpulmonary hypertension |
| spellingShingle | E. Z. Golukhova Inessa Viktorovna Slivneva M. M. Rybka M. L. Mamalyga M. N. Alekhin I. V. Klyuchnikov D. E. Antonova D. I. Marapov Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 Российский кардиологический журнал transthoracic echocardiography echocardiography estimated pulmonary artery systolic pressure covid-19 predictor of unfavorable outcome prognostic model pulmonary hypertension |
| title | Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 |
| title_full | Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 |
| title_fullStr | Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 |
| title_full_unstemmed | Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 |
| title_short | Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19 |
| title_sort | pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with covid 19 |
| topic | transthoracic echocardiography echocardiography estimated pulmonary artery systolic pressure covid-19 predictor of unfavorable outcome prognostic model pulmonary hypertension |
| url | https://russjcardiol.elpub.ru/jour/article/view/4136 |
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