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. 2021 Oct;44(10):1475-1481.
doi: 10.1002/clc.23708. Epub 2021 Aug 6.

Prognostic implications of biventricular strain measurement in COVID-19 patients by speckle-tracking echocardiography

Mohammad Khani  1 , Sasan Tavana  2 , Mohammadreza Tabary  3 , Zahra Naseri Kivi  1 , Isa Khaheshi  1
Affiliations

Prognostic implications of biventricular strain measurement in COVID-19 patients by speckle-tracking echocardiography

Mohammad Khani et al. Clin Cardiol. 2021 Oct.

Abstract

Background: Recent reports have indicated the beneficial role of strain measurement in COVID-19 patients.

Hypothesis: To determine the association between right and left global longitudinal strain (RVGLS, LVGLS) and COVID-19 patients' outcomes.

Methods: Hospitalized COVID-19 patients between June and August 2020 were included. Two-dimensional echocardiography and biventricular global longitudinal strain measurement were performed. The outcome measure was defined as mortality, ICU admission, and need for intubation. Appropriate statistical tests were used to compare different groups.

Results: In this study 207 patients (88 females) were enrolled. During 64 ± 4 days of follow-up, 22 (10.6%) patients died. Mortality, ICU admission, and intubation were significantly associated with LVGLS and RVGLS tertiles. LVGLS tertiles could predict poor outcome with significant odds ratios in the total population (OR = 0.203, 95% CI: 0.088-0.465; OR = 0.350, 95% CI: 0.210-0.585; OR = 0.354, 95% CI: 0.170-0.736 for mortality, ICU admission, and intubation). Although odds ratios of LVGLS for the prediction of outcome were statistically significant among hypertensive patients, these odds ratios did not reach significance among non-hypertensive patients. RVGLS tertiles revealed significant odds ratios for the prediction of mortality (OR = 0.322, 95% CI: 0.162-0.640), ICU admission (OR = 0.287, 95% CI: 0.166-0.495), and need for intubation (OR = 0.360, 95% CI: 0.174-0.744). Odds ratios of RVGLS remained significant even after adjusting for hypertension when considering mortality and ICU admission.

Conclusion: RVGLS and LVGLS can be acceptable prognostic factors to predict mortality, ICU admission, and intubation in hospitalized COVID-19 patients. However, RVGLS seems more reliable, as it is not confounded by hypertension.

Keywords: COVID-19; echocardiography; prognosis; speckle-tracking echocardiography; strain.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study flow chart
FIGURE 2
FIGURE 2
ROC curves for the sensitivity and specificity analysis of speckle tracking echocardiography. LVGLS: A. Mortality, B. ICU admission, C. Intubation. RVGLS: D. Mortality, E. ICU admission, F. Intubation
See this image and copyright information in PMC

Comment in

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