Echocardiographic Evaluation of Right Ventricular Function in ARDS
Patients caused by COVID-19 pneumonia
Abstract
Backgound: To investigate the right heart function in COVID-19
(coronavirus disease 2019) patients with acute respiratory distress
syndrome (ARDS). Methods: A retrospective analysis of 49 COVID-19
patients with ARDS was performed. Patients were divided into severe and
critically severe group according to severity of illness. Age-matched
healthy volunteers were recruited serving as a control group. The
cardiac cavity diameters, tricuspid annular plane systolic excursion
(TAPSE), tricuspid valve regurgitation pressure gradient biggest (TRPG),
pulmonary arterial systolic pressure (PASP), maximum inferior vena cava
diameter (IVCmax) and minimum diameter (IVCmin), and inferior vena cava
collapse index (ICV-CI) were measured using echocardiography. Results:
We found the TAPSE was significantly decreased in pneumonia patients
compared to healthy subjects (P<0.0001), which was
significantly lower in critically severe patients (P=0.0068). TAPSE was
less than 17mm in 3 (8.6%) severe and 5 (35.7%) critically severe
patients. There were no significant differences in PASP and TRPG between
severe and critically severe patients. The IVCmax and IVCmin were
significantly increased in critically severe patients compared to
healthy subjects and severe patients (P < 0.01), whereas
ICV-CI was significantly decreased (P < 0.05). COVID-19
patients had significantly larger right atrium and ventricle than
healthy controls (P < 0.01). The left ventricular ejection
fraction (LVEF) in critically severe patients was significantly lower
than that in severe patients and healthy controls (P < 0.05).
Conclusion: Right ventricular function is impaired in critically severe
COVID-19 patients. The assessment and protection of the right heart
function in COVID-19 patients should be strengthened.