Prognostic value of right ventricular dilatation on computed tomography pulmonary angiogram for predicting adverse clinical events in severe COVID-19 pneumonia
Copyright © 2023 Beyls, Vial, Lefebvre, Muller, Hanquiez, Besserve, Guilbart, Haye, Bernasinski, Huette, Dupont, Abou-Arab, Jounieaux and Mahjoub..
Background: Right ventricle dilatation (RVD) is a common complication of non-intubated COVID-19 pneumonia caused by pro-thrombotic pneumonitis, intra-pulmonary shunting, and pulmonary vascular dysfunction. In several pulmonary diseases, RVD is routinely measured on computed tomography pulmonary angiogram (CTPA) by the right ventricle-to-left ventricle (LV) diameter ratio > 1 for predicting adverse events.
Objective: The aim of the study was to evaluate the association between RVD and the occurrence of adverse events in a cohort of critically ill non-intubated COVID-19 patients.
Methods: Between February 2020 and February 2022, non-intubated patients admitted to the Amiens University Hospital intensive care unit for COVID-19 pneumonia with CTPA performed within 48 h of admission were included. RVD was defined by an RV/LV diameter ratio greater than one measured on CTPA. The primary outcome was the occurrence of an adverse event (renal replacement therapy, extracorporeal membrane oxygenation, 30-day mortality after ICU admission).
Results: Among 181 patients, 62% (n = 112/181) presented RVD. The RV/LV ratio was 1.10 [1.05-1.18] in the RVD group and 0.88 [0.84-0.96] in the non-RVD group (p = 0.001). Adverse clinical events were 30% and identical in the two groups (p = 0.73). In Receiving operative curves (ROC) analysis, the RV/LV ratio measurement failed to identify patients with adverse events. On multivariable Cox analysis, RVD was not associated with adverse events to the contrary to chest tomography severity score > 10 (hazards ratio = 1.70, 95% CI [1.03-2.94]; p = 0.04) and cardiovascular component (> 2) of the SOFA score (HR = 2.93, 95% CI [1.44-5.95], p = 0.003).
Conclusion: Right ventricle (RV) dilatation assessed by RV/LV ratio was a common CTPA finding in non-intubated critical patients with COVID-19 pneumonia and was not associated with the occurrence of clinical adverse events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Frontiers in medicine - 10(2023) vom: 21., Seite 1213775 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Beyls, Christophe [VerfasserIn] |
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| Links: |
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| Themen: |
ARDS |
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| Anmerkungen: |
Date Revised 17.08.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmed.2023.1213775 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360827071 |
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| 100 | 1 | |a Beyls, Christophe |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic value of right ventricular dilatation on computed tomography pulmonary angiogram for predicting adverse clinical events in severe COVID-19 pneumonia |
| 264 | 1 | |c 2023 | |
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| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2023 Beyls, Vial, Lefebvre, Muller, Hanquiez, Besserve, Guilbart, Haye, Bernasinski, Huette, Dupont, Abou-Arab, Jounieaux and Mahjoub. | ||
| 520 | |a Background: Right ventricle dilatation (RVD) is a common complication of non-intubated COVID-19 pneumonia caused by pro-thrombotic pneumonitis, intra-pulmonary shunting, and pulmonary vascular dysfunction. In several pulmonary diseases, RVD is routinely measured on computed tomography pulmonary angiogram (CTPA) by the right ventricle-to-left ventricle (LV) diameter ratio > 1 for predicting adverse events | ||
| 520 | |a Objective: The aim of the study was to evaluate the association between RVD and the occurrence of adverse events in a cohort of critically ill non-intubated COVID-19 patients | ||
| 520 | |a Methods: Between February 2020 and February 2022, non-intubated patients admitted to the Amiens University Hospital intensive care unit for COVID-19 pneumonia with CTPA performed within 48 h of admission were included. RVD was defined by an RV/LV diameter ratio greater than one measured on CTPA. The primary outcome was the occurrence of an adverse event (renal replacement therapy, extracorporeal membrane oxygenation, 30-day mortality after ICU admission) | ||
| 520 | |a Results: Among 181 patients, 62% (n = 112/181) presented RVD. The RV/LV ratio was 1.10 [1.05-1.18] in the RVD group and 0.88 [0.84-0.96] in the non-RVD group (p = 0.001). Adverse clinical events were 30% and identical in the two groups (p = 0.73). In Receiving operative curves (ROC) analysis, the RV/LV ratio measurement failed to identify patients with adverse events. On multivariable Cox analysis, RVD was not associated with adverse events to the contrary to chest tomography severity score > 10 (hazards ratio = 1.70, 95% CI [1.03-2.94]; p = 0.04) and cardiovascular component (> 2) of the SOFA score (HR = 2.93, 95% CI [1.44-5.95], p = 0.003) | ||
| 520 | |a Conclusion: Right ventricle (RV) dilatation assessed by RV/LV ratio was a common CTPA finding in non-intubated critical patients with COVID-19 pneumonia and was not associated with the occurrence of clinical adverse events | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ARDS | |
| 650 | 4 | |a AVDS | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a angiogram | |
| 650 | 4 | |a computed tomography | |
| 650 | 4 | |a pneumonia | |
| 650 | 4 | |a right ventricle dilatation | |
| 700 | 1 | |a Vial, Jeremie |e verfasserin |4 aut | |
| 700 | 1 | |a Lefebvre, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Muller, Charlotte |e verfasserin |4 aut | |
| 700 | 1 | |a Hanquiez, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Besserve, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Guilbart, Mathieu |e verfasserin |4 aut | |
| 700 | 1 | |a Haye, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Bernasinski, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Huette, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Dupont, Hervé |e verfasserin |4 aut | |
| 700 | 1 | |a Abou-Arab, Osama |e verfasserin |4 aut | |
| 700 | 1 | |a Jounieaux, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Mahjoub, Yazine |e verfasserin |4 aut | |
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