5 research outputs found
Myocardial Work in Patients Hospitalized With COVIDâ19:Relation to Biomarkers, COVIDâ19 Severity, and AllâCause Mortality
BACKGROUND: COVIDâ19 infection has been hypothesized to affect left ventricular function; however, the underlying mechanisms and the association to clinical outcome are not understood. The global work index (GWI) is a novel echocardiographic measure of systolic function that may offer insights on cardiac dysfunction in COVIDâ19. We hypothesized that GWI was associated with disease severity and allâcause death in patients with COVIDâ19. METHODS AND RESULTS: In a multicenter study of patients admitted with COVIDâ19 (n=305), 249 underwent pressureâstrain loop analyses to quantify GWI at a median time of 4âdays after admission. We examined the association of GWI to cardiac biomarkers (troponin and NTâproBNP [Nâterminal proâBâtype natriuretic peptide]), disease severity (oxygen requirement and CRP [Câreactive protein]), and allâcause death. Patients with elevated troponin (n=71) exhibited significantly reduced GWI (1508 versus 1707âmmâHg%; P=0.018). A curvilinear association to NTâproBNP was observed, with increasing NTâproBNP once GWI decreased below 1446âmmâHg%. Moreover, GWI was significantly associated with a higher oxygen requirement (relative increase of 6% per 100âmmâHg% decrease). No association was observed with CRP. Of the 249 patients, 37 died during followâup (median, 58âdays). In multivariable Cox regression, GWI was associated with allâcause death (hazard ratio, 1.08 [95% CI, 1.01â1.15], per 100âmmâHg% decrease), but did not increase Câstatistics when added to clinical parameters. CONCLUSIONS: In patients admitted with COVIDâ19, our findings indicate that NTâproBNP and troponin may be associated with lower GWI, whereas CRP is not. GWI was independently associated with allâcause death, but did not provide prognostic information beyond readily available clinical parameters. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04377035
Myocardial Work in Patients Hospitalized With COVIDâ19: Relation to Biomarkers, COVIDâ19 Severity, and AllâCause Mortality
Background COVIDâ19 infection has been hypothesized to affect left ventricular function; however, the underlying mechanisms and the association to clinical outcome are not understood. The global work index (GWI) is a novel echocardiographic measure of systolic function that may offer insights on cardiac dysfunction in COVIDâ19. We hypothesized that GWI was associated with disease severity and allâcause death in patients with COVIDâ19. Methods and Results In a multicenter study of patients admitted with COVIDâ19 (n=305), 249 underwent pressureâstrain loop analyses to quantify GWI at a median time of 4âdays after admission. We examined the association of GWI to cardiac biomarkers (troponin and NTâproBNP [Nâterminal proâBâtype natriuretic peptide]), disease severity (oxygen requirement and CRP [Câreactive protein]), and allâcause death. Patients with elevated troponin (n=71) exhibited significantly reduced GWI (1508 versus 1707âmmâHg%; P=0.018). A curvilinear association to NTâproBNP was observed, with increasing NTâproBNP once GWI decreased below 1446âmmâHg%. Moreover, GWI was significantly associated with a higher oxygen requirement (relative increase of 6% per 100âmmâHg% decrease). No association was observed with CRP. Of the 249 patients, 37 died during followâup (median, 58âdays). In multivariable Cox regression, GWI was associated with allâcause death (hazard ratio, 1.08 [95% CI, 1.01â1.15], per 100âmmâHg% decrease), but did not increase Câstatistics when added to clinical parameters. Conclusions In patients admitted with COVIDâ19, our findings indicate that NTâproBNP and troponin may be associated with lower GWI, whereas CRP is not. GWI was independently associated with allâcause death, but did not provide prognostic information beyond readily available clinical parameters. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04377035