Structural and functional сhanges of the right ventricle in COVID-19 according to echocardiography

Authors: Golukhova E.Z.1, Slivneva I.V.1, Rybka M.M.1, Mamalyga M.L.1, Alekhin M.N.2, Klyuchnikov I.V.1, Antonova D.E.1, Marapov D.I.3, Volkovskaya I.V.1

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation 2 Central Clinical Hospital with a Polyclinic, Presidential Administration, Moscow, 121359, Russian Federation. 3 Department of Public Health, Economics and Health Management of the Kazan State Medical Academy Affiliate of the Russian Medical Academy of Continuing Professional Education, Kazan, 420012, Russian Federation.

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2020-14-3-206-223

For citation: Golukhova E.Z., Slivneva I.V., Rybka M.M., Mamalyga M.L., Alekhin M.N., Klyuchnikov I.V., Antonova D.E., Marapov D.I., Volkovskaya I.V. Structural and functional сhanges of the right ventricle in COVID-19 according to echocardiography. Creative Cardiology. 2020; 14 (3): 206–23 (in Russ.). DOI: 10.24022/1997-3187-2020-14-3-206-223

Received / Accepted:  10.08.2020 / 20.08.2020

Keywords: COVID-19 echocardiography right ventricle systolic function

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Abstract

Objective. Comprehensive echocardiographic assessment of right ventricle (RV) dysfunction depending on the course of COVID-19.

Material and methods. A study of 109 patients with COVID-19. The patients were divided into 2 groups: group 1 – with a compensated state of COVID-19 (n=86) and group 2 – with a severe state, decompensated according to the right ventricular failure (n=23). All patients underwent a comprehensive echocardiographic examination at baseline, including tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE). In group 2, parameters were assessed in dynamics (stage A – initially, stage B – disease progression according to computed tomography data). Hospitalization period from the onset of the disease – 7 days (Q1–Q3: 5–10 days).

Results. There was a statistically significant difference among the Echo parameters when comparing 1-2B groups: TAPSE (tricuspid annular plane systolic excursion) (р=0.032), tricuspid annular peak systolic velocity (S') (р=0.032), IVA RV (isovolumetric myocardial acceleration of RV) global (р=0.035) and apical (р=0.039), Strain RV at the middle level (р=0.006) and global (р=0.014), LS RV (right ventricular longitudinal strain) basal, middle and global (р<0.001), LS RV apical (р=0.022), pulmonary artery pressure (р<0.001). When comparing group 2 at stages A and B, significant differences were noted about: FAC RV (right ventricular fractional area change) (р=0.033), IVA RV global (р=0.041), Strain RV at the middle level (р=0.047), pulmonary artery pressure (р<0.001).

Conclusion. The determination of the mean LS RV (STE) values, in contrast to the peak values in the TDI mode, demonstrated a higher diagnostic value in identifying signs of RV systolic dysfunction. Early detection of signs of progression of right ventricular dysfunction makes it possible to more accurately predict the progression of COVID-19 and, thereby, look for new ways to solve the problem of timely maintenance therapy in the future.

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About Authors

  • Голухова Елена Зеликовна, доктор мед. наук, профессор, академик РАН, заведующий кафедрой, и. о. директора НМИЦССХ им. А.Н. Бакулева, зам. главного редактора журнала, ORCID
  • Сливнева Инесса Викторовна, канд. мед. наук, науч. сотр., доцент, ORCID
  • Рыбка Михаил Михайлович, доктор мед. наук, профессор, зам. директора по анестезиологии и реаниматологии, заведующий отделением, ORCID
  • Мамалыга Максим Леонидович, доктор мед. наук, ст. науч. сотр., ORCID
  • Алехин Михаил Николаевич, доктор мед. наук, профессор, вице-президент РАСУДМ, заведующий отделением, ORCID
  • Ключников Иван Вячеславович, доктор мед. наук, профессор, гл. науч. сотр., ORCID
  • Антонова Диана Евгеньевна, ординатор, ORCID
  • Марапов Дамир Ильдарович, канд. мед. наук, доцент, ORCID
  • Волковская Ирина Васильевна, канд. мед. наук, руководитель отдела, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery