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. 2022 Feb:14:100134.
doi: 10.1016/j.ahjo.2022.100134. Epub 2022 Apr 18.

Hyperdynamic left ventricular ejection fraction is associated with higher mortality in COVID-19 patients

Annas Rahman  1 , Max Ruge  2 , Alex Hlepas  1 , Gatha Nair  1 , Joanne Gomez  3 , Jeanne du Fay de Lavallaz  1 , Setri Fugar  3 , Nusrat Jahan  3 , Annabelle Santos Volgman  3 , Kim A Williams  3 , Anupama Rao  3 , Karolina Marinescu  3 , Tisha Suboc  3
Affiliations

Hyperdynamic left ventricular ejection fraction is associated with higher mortality in COVID-19 patients

Annas Rahman et al. Am Heart J Plus. 2022 Feb.

Abstract

Study objective: To compare the characteristics and outcomes of COVID-19 patients with a hyperdynamic LVEF (HDLVEF) to those with a normal or reduced LVEF.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: Of the 1682 adult patients hospitalized with COVID-19, 419 had a transthoracic echocardiogram (TTE) during admission and met study inclusion criteria.

Interventions: Participants were divided into reduced (LVEF < 50%), normal (≥50% and <70%), and hyperdynamic (≥70%) LVEF groups.

Main outcome measures: LVEF was assessed as a predictor of 60-day mortality. Logistic regression was used to adjust for age and BMI.

Results: There was no difference in 60-day mortality between patients in the reduced LVEF and normal LVEF groups (adjusted odds ratio [aOR] 0.87, p = 0.68). However, patients with an HDLVEF were more likely to die by 60 days compared to patients in the normal LVEF group (aOR 2.63 [CI: 1.36-5.05]; p < 0.01). The HDLVEF group was also at higher risk for 60-day mortality than the reduced LVEF group (aOR 3.34 [CI: 1.39-8.42]; p < 0.01).

Conclusion: The presence of hyperdynamic LVEF during a COVID-19 hospitalization was associated with an increased risk of 60-day mortality, the requirement for mechanical ventilation, vasopressors, and intensive care unit.

Keywords: COVID-19; COVID-19, coronavirus disease 2019; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; Heart failure; Hyperdynamic; ICU, intensive care unit; LVEF, left ventricular ejection fraction; Left ventricular ejection fraction; MACE, major adverse cardiovascular events; NLVEF, normal left ventricular ejection fraction; RLVEF, reduced left ventricular ejection fraction; SARS-CoV-2; TTE, transthoracic echocardiogram.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Study cohort selection diagram.
Fig. 2
Fig. 2
Kaplan-Meier survival estimates comparing mortality in COVID-19 patients with normal vs. hyperdynamic left ventricular ejection fractions.
Fig. 3
Fig. 3
Multivariable odds ratios, adjusted for age and body mass index, with 95% confidence intervals of primary (A) and secondary (B, C, D, E, and F) outcomes. OR = odds ratio; CI = confidence interval; ICU = intensive care unit.
See this image and copyright information in PMC

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