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Usefulness of Right Ventricular Longitudinal Shortening Fraction to Detect Right Ventricular Dysfunction in Acute Cor Pulmonale Related to COVID-19

Abstract : Objective: To compare two-dimensional-speckle tracking echocardiographic parameters (2D-STE) and classic echocardiographic parameters of right ventricular (RV) systolic function in patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (CARDS) complicated or not by acute cor pulmonale (ACP). Design: Prospective, between March 1, 2020 and April 15, 2020. Setting: Intensive care unit of Amiens University Hospital (France). Participants: Adult patients with moderate-to-severe CARDS under mechanical ventilation for fewer than 24 hours. Interventions: None. Measurements and Main Results: Tricuspid annular displacement (TAD) parameters (TAD-septal, TAD-lateral, and RV longitudinal shortening fraction [RV-LSF]), RV global longitudinal strain (RV-GLS), and RV free wall longitudinal strain (RVFWLS) were measured using transesophageal echocardiography with a dedicated software and compared with classic RV systolic parameters (RV-FAC, S' wave, and tricuspid annular plane systolic excursion [TAPSE]). RV systolic dysfunction was defined as RV-FAC <35%. Twenty-nine consecutive patients with moderateto-severe CARDS were included. ACP was diagnosed in 12 patients (41%). 2D-STE parameters were markedly altered in the ACP group, and no significant difference was found between patients with and without ACP for classic RV parameters (RV-FAC, S' wave, and TAPSE). In the ACP group, RV-LSF (17% [14%-22%]) had the best correlation with RV-FAC (r = 0.79, p < 0.001 v r = 0.27, p = 0.39 for RVGLS and r = 0.28, p = 0.39 for RVFWLS). A RV-LSF cut-off value of 17% had a sensitivity of 80% and a specificity of 86% to identify RV systolic dysfunction. Conclusions: Classic RV function parameters were not altered by ACP in patients with CARDS, contrary to 2D-STE parameters. RV-LSF seems to be a valuable parameter to detect early RV systolic dysfunction in CARDS patients with ACP. (C) 2021 Elsevier Inc. All rights reserved.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03574710
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Soumis le : mardi 15 février 2022 - 11:44:39
Dernière modification le : mercredi 16 février 2022 - 03:39:59

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Christophe Beyls, Yohann Bohbot, Pierre Huette, Thomas Booz, Camille Daumin, et al.. Usefulness of Right Ventricular Longitudinal Shortening Fraction to Detect Right Ventricular Dysfunction in Acute Cor Pulmonale Related to COVID-19. Journal of cardiothoracic and vascular anesthesia, 2021, 35 (12), pp.3594-3603. ⟨10.1053/j.jvca.2021.01.025⟩. ⟨hal-03574710⟩

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