Increased RV:LV ratio on chest CT-angiogram in COVID-19 is a marker of adverse outcomes.

Autor: Tao R; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Burivalova Z; Nelson Institute for Environmental Studies, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Masri SC; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Dharmavaram N; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Baber A; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Deaño R; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Hess T; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Dhingra R; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Runo J; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Pulmonary and Critical Care, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Jarjour N; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.; Department of Medicine-Division of Pulmonary and Critical Care, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Vanderpool RR; Department of Biomedical Engineering, The University of Arizona, 1127 E. James E. Rogers Way, Tucson, AZ, 85721, USA., Chesler N; Department of Biomedical Engineering, The Henry Samueli School of Engineering, University of California, Irvine, Irvine, CA, 92697, USA., Kusmirek JE; Department of Radiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Eldridge M; Department of Pediatrics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA., Francois C; Mayo Clinic Radiology, 200 First St. SW, Rochester, MN, 55905, USA., Raza F; Department of Medicine, CSC-E5/582B, University of Wisconsin Hospitals and Clinics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA. fraza@medicine.wisc.edu.; Department of Medicine-Division of Cardiology, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA. fraza@medicine.wisc.edu.
Jazyk: angličtina
Zdroj: The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology [Egypt Heart J] 2022 May 08; Vol. 74 (1), pp. 37. Date of Electronic Publication: 2022 May 08.
DOI: 10.1186/s43044-022-00274-w
Abstrakt: Background: Right ventricular (RV) dilation has been used to predict adverse outcomes in acute pulmonary conditions. It has been used to categorize the severity of novel coronavirus infection (COVID-19) infection. Our study aimed to use chest CT-angiogram (CTA) to assess if increased RV dilation, quantified as an increased RV:LV (left ventricle) ratio, is associated with adverse outcomes in the COVID-19 infection, and if it occurs out of proportion to lung parenchymal disease.
Results: We reviewed clinical, laboratory, and chest CTA findings in COVID-19 patients (n = 100), and two control groups: normal subjects (n = 10) and subjects with organizing pneumonia (n = 10). On a chest CTA, we measured basal dimensions of the RV and LV in a focused 4-chamber view, and dimensions of pulmonary artery (PA) and aorta (AO) at the PA bifurcation level. Among the COVID-19 cohort, a higher RV:LV ratio was correlated with adverse outcomes, defined as ICU admission, intubation, or death. In patients with adverse outcomes, the RV:LV ratio was 1.06 ± 0.10, versus 0.95 ± 0.15 in patients without adverse outcomes. Among the adverse outcomes group, compared to the control subjects with organizing pneumonia, the lung parenchymal damage was lower (22.6 ± 9.0 vs. 32.7 ± 6.6), yet the RV:LV ratio was higher (1.06 ± 0.14 vs. 0.89 ± 0.07). In ROC analysis, RV:LV ratio had an AUC = 0.707 with an optimal cutoff of RV:LV ≥ 1.1 as a predictor of adverse outcomes. In a validation cohort (n = 25), an RV:LV ≥ 1.1 as a cutoff predicted adverse outcomes with an odds ratio of 76:1.
Conclusions: In COVID-19 patients, RV:LV ratio ≥ 1.1 on CTA chest is correlated with adverse outcomes. RV dilation in COVID-19 is out of proportion to parenchymal lung damage, pointing toward a vascular and/or thrombotic injury in the lungs.
(© 2022. The Author(s).)
Databáze: MEDLINE
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