IMR Press / RCM / Volume 21 / Issue 4 / DOI: 10.31083/j.rcm.2020.04.159
Open Access Original Research
Acute right ventricular dysfunction in severe COVID-19 pneumonia
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1 Department of Intensive Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, P. R. China
2 Department of General Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, 150088, Heilongjiang, P. R. China
3 Department of Echocardiography Lab, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, P. R. China
4 Department of Intensive Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, P. R. China
*Correspondence: yymm1976@sina.com (Ming Ye); drkaijiang1@126.com (Kai-Jiang Yu)
These authors contributed equally.
Rev. Cardiovasc. Med. 2020, 21(4), 635–641; https://doi.org/10.31083/j.rcm.2020.04.159
Submitted: 3 August 2020 | Revised: 28 October 2020 | Accepted: 31 October 2020 | Published: 30 December 2020
Copyright: © 2020 Li et al. Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

To investigate the right heart function in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS), a retrospective analysis of 49 COVID-19 patients with ARDS was performed. Patients were divided into severe group and critically-severe group according to the severity of illness. Age-matched healthy volunteers were recruited 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. We found that the TAPSE was significantly decreased in pneumonia patients compared to healthy subjects (P < 0.0001), and it was significantly lower in critically-severe patients (P = 0.0068). The TAPSE was less than 17 mm in three (8.6%) severe and five (35.7%) critically-severe patients. In addition, the TAPSE was significantly decreased in severe ARDS patients than in mild ARDS patients. The IVCmax and IVCmin were significantly increased in critically-severe patients compared to healthy subjects and severe patients (P < 0.01), whereas the 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). Right ventricular function was impaired in critically-severe COVID-19 patients. The assessment and protection of the right heart function in COVID-19 patients should be strengthened.

Keywords
Coronavirus disease 2019
acute respiratory distress syndrome
right ventricular function
echocardiography
retrospective study
Figures
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