Imaging data in COVID-19 patients: focused on echocardiographic findings

To assess imaging data in COVID-19 patients and its association with clinical course and survival and 86 consecutive patients (52 males, 34 females, mean age = 58.8 year) with documented COVID-19 infection were included. Seventy-eight patients (91) were in severe stage of the disease. All patients underwent transthoracic echocardiography. Mean LVEF was 48.1 and mean estimated systolic pulmonary artery pressure (sPAP) was 27.9 mmHg. LV diastolic dysfunction was mildly abnormal in 49 patients (57.6) and moderately abnormal in 7 cases (8.2). Pericardial effusion was present in 5/86 (minimal in size in 3 cases and mild- moderate in 2). In 32/86 cases (37.2), the severity of infection progressed from �severe� to �critical�. Eleven patients (12.8) died. sPAP and computed tomography score were associated with disease progression (P value = 0.002, 0.002 respectively). Tricuspid annular plane systolic excursion (TAPSE) was significantly higher in patients with no disease progression compared with those who deteriorated (P value = 0.005). Pericardial effusion (minimal, mild or moderate) was detected more often in progressive disease (P = 0.03). sPAP was significantly lower among survivors (P value = 0.007). Echocardiographic findings (including systolic PAP, TAPSE and pericardial effusion), total CT score may have prognostic and therapeutic implication in COVID-19 patients. © 2021, The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature

The echocardiographic estimation of left ventricular filling pressures in patients with mitral valve stenosis

"nBackground: Estimation of Left Ventricular End Diastolic Pressure (LVEDP) among patients with Mitral Stenosis (MS) helps to diagnose diastolic dysfunction and to explain their symptoms. However, Conventional Doppler measurements have limitation in predicting of LVEDP. This study sought to establish whether the correlation between measurements derived from Tissue Doppler echocardiography and LVEDP remains valid in the setting of severe mitral stenosis. "n"nMethods: Thirty three patients with moderate to severe MS who had indication for left heart catheterization enrolled during 1387-88 in Imam Khomeini Hospital in Tehran, Iran. The mean diastolic transmitral pressure gradient and mitral valve area (MVA) were calculated, and Two-dimensional, M-mode, color Doppler and tissue Doppler Imaging indices such as: early diastolic mitral inflow velocity (E), annular early diastolic velocity (Ea), E/A ratio, Isovolemic relaxation time (IVRT), Pulmonary Vein systolic and diastolic flow velocities, Velocity Propagation, LA size, TE-Ea, Tei Index were obtained in maximum three hours before cardiac catheterization. The echocardiography analysis was performed offline without knowledge of hemodynamic data Linear correlation and multiple linear regression were used for analysis. p< 0.05 was considered significant. "n"nResults: In univariate analysis, E/Ea was associated with LVEDP significantly (p = 0.04, r = 0.38). There was also a significant correlation between TE-Ea and LVDP (p = 0.01, r = -0.44). In multiple linear regression Tei Index (ß = 0.4, p< 0.02), and TE-Ea (ß = 0.5, p = 0.02) were showed as independent predictors of LVEDP (R2 = 49%). "n"nConclusion: Although we observed a moderate correlation between Doppler measurements and LVEDP in patients with severe MS, more similar studies are required

"Oral ascorbic acid in combination with beta blockers in prevention of atrial fibrillation after Coronary Artery Bypass Graft "

Background: Adrenergic beta antagonists are not sufficient to prevent atrial fibrillation after coronary artery bypass graft (CABG). This study was designed to evaluate the effect of ascorbic acid as an adjunct to beta-blockers in prevention of post-CABG atrial fibrillation Methods: Patients who were more than 50 years old and scheduled to undergo CABG were included if they were treated with beta-blockers at least 1 week before surgery. Patients with previous history of atrial fibrillation, AV block, heart rate <50 /min, end-stage renal disease, severe pulmonary or liver disease and those who were taking digoxin or class I and III anti-arrhythmics or had pacemakers were not included. Ascorbic acid group were prescribed 2 gm of ascorbic acid, the night before the surgery, and 1 gm twice daily for 5 days after surgery. Beta blockers continued in both group after surgery. Telemetry monitoring was performed in ICU and Holter monitoring was performed for 4 days. Results: Fifty patients completed the study as ascorbic acid and 50 as control group. The population was 60.19 ± 7.14 years old and 67% were male. The incidence of postoperative atrial fibrillation was 4% in the ascorbic acid group and 26% in control group (odds ratio=0.119, 95% confidence interval: 0.025 to 0.558, P=0.002) Conclusion: Ascorbic acid is well-tolerated, relatively safe and seems effective. Therefore it can be prescribed as an adjunct to beta-blockers for prophylaxis of post-CABG atrial fibrillation