Comprehensive temporal analysis of right ventricular function and pulmonary haemodynamics in mechanically ventilated COVID-19 ARDS patients

Tsolaki, Vasiliki; Zakynthinos, George E.; Karavidas, Nikitas; Vazgiourakis, Vasileios; Papanikolaou, John; Parisi, Kyriaki; Zygoulis, Paris; Makris, Demosthenes; Zakynthinos, Epaminondas

doi:10.1186/s13613-024-01241-1

Annals of Intensive Care

Table 2 Echocardiographic variables in survivors and non-survivors upon admission and follow-up

From: Comprehensive temporal analysis of right ventricular function and pulmonary haemodynamics in mechanically ventilated COVID-19 ARDS patients

Echocardiographic Variable	COVID-19 ARDS survivors (n = 56)^a			COVID-19 ARDS non-survivors (n = 120)
Echocardiographic Variable	Admission	Day 10	p value	Admission	Day 10	p value
Age, years	65.9 ± 1.5			67.4 ± 1.0
Sex, %	39 (69.6%)			80 (66.7%)
APACHE II score	16.2 ± 0.9			17.3 ± 0.7
SOFA score	7.5 ± 0.2			8.05 ± 0.2
Right ventricle
RVEDA/LVEDA	0.8 ± 0.05 (49)	0.6 ± 0.03 (49)#	0.001	0.81 ± 0.03 (78)	0.89 ± 0.03 (78)	0.864
ACP	12 (24.5)	5 (10.2)	0.073	21 (26.9)	14 (17.9)	0.850
RVEDA, cm²	22.1 ± 0.6 (49)	17.8 ± 0.8 (49)*	< 0.0001	23 ± 0.8 (78)	24.4 ± 0.8 (78)	0.097
RVESA, cm²	14.1 ± 0.5 (49)	10.3 ± 0.5 (49)#	< 0.0001	14.5 ± 0.6 (78)	15.2 ± 0.8 (78)	0.357
RV FAC, %	37.4 ± 1.6 (49)	41.1 ± 1.9 (49)	0.073	35.9 ± 1.6 (78)	38.9 ± 1.7 (78)	0.253
RVEDV^b, ml	128.1 ± 13.9 (29)*	92.8 ± 8.4 (29)*	0.006	110.91 ± 6.02 (44)	121.3 ± 6.17 (44)	0.004
RVESV^b, ml	82.4 ± 10.2 (29)*	52.2 ± 5.3 (29)*	0.002	67.6 ± 3.9 (44)	73.6 ± 4.4 (44)	0.127
RVEF^b (%)	36.5 ± 2.9 (29)	46.6 ± 2.1 (29)*	0.001	38.8 ± 1.5 (44)	39.1 ± 2 (44)	0.916
TAPSE, mm	19.8 ± 0.6 (51)	21.5 ± 0.5 (51)	0.008	20.3 ± 0.6 (73)	22 ± 2 (73)	0.404
RV S’, cm/sec	16.8 ± 0.8 (53)	19.9 ± 0.7 (53)#	0.002	15.3 ± 0.6 (74)	14.1 ± 0.5 (74)	0.045
RV IVA, m/sec²	3.98 ± 0.17 (53)	4.1 ± 0.17 (53)	0.318	3.66 ± 0.12 (74)	3.77 ± 0.14 (74)	0.260
RV–LS, %	− 13.6 ± 0.7 (42)	− 16.7 ± 0.8 (42)#	0.001	− 14.3 ± 0.8 (64)	− 12.6 ± 0.5 (64)	0.017
VTI_RVOT, cm	17 ± 0.7 (41)	19.4 ± 0.5 (41)#	0.011	16.2 ± 0.5 (60)	16.1 ± 0.4 (60)	0.987
PASP, mmHg	36.1 ± 2.4 (43)	20.1 ± 3 (43)#	< 0.0001	34.9 ± 1.8 (66)	36.3 ± 1.1 (66)	0.347
PASP/VTI_LVOT, mmHg/cm	2 ± 0.2 (43)	0.9 ± 0.1 (43)#	< 0.0001	2 ± 0.2 (65)	1.9 ± 0.1 (65)	0.543
PASP/VTIR_VOT, mmHg/cm	2.5 ± 1.4 (34)	1.1 ± 0.7 (34)#	< 0.0001	2.5 ± 1.5 (57)	2.4 ± 0.9 (57)	0.445
Pulmonary AcT, msec	61 ± 2.5 (41)	84.7 ± 2.4 (41)#	< 0.0001	66.8 ± 2.6 (60)	62.6 ± 2.3 (60)	0.096
RVOT notch	15 (23.4%)	4 (6.3%) *	0.033	21 (35%)	13 (21.6%)	0.321
VAC_R, mm/mmHg	0.80 ± 0.1 (43)	1.5 ± 0.1 (43)#	< 0.0001	0.73 ± 0.07 (60)	0.66 ± 0.08 (60)	0.497
Left ventricle
LVEDD, mm	4.66 ± 0.1 (49)	4.62 ± 0.1 (49)	0.576	4.55 ± 0.06 (78)	4.53 ± 0.06 (78)	0.760
IVS, mm	0.9 ± 0.01 (49)			0.92 ± 0.01 (78)
LVEDA, cm²	27.2 ± 1.03 (49)	27.1 ± 0.8 (49)	0.917	29.2 ± 0.7 (78)	27.9 ± 0.7 (78)	0.097
LVESA, cm²	17.4 ± 2.2 (49)	15.9 ± 1.5 (49)	0.555	16.3 ± 1.9 (78)	12.8 ± 1.2 (78)	0.357
VTI_LVOT, cm	19.9 ± 0.1 (49)	21.8 ± 0.5 (49)*	0.005	20.2 ± 0.7 (78)	20.1 ± 0.5 (78)	0.914
LVEDV, ml (2D)	81.5 ± 4.5 (49)	85.9 ± 3.2 (49)	0.441	85.5 ± 4.9 (78)	80.7 ± 3.1 (78)	0.361
LVESV, ml (2D)	30.1 ± 2.5 (49)	32.1 ± 1.9 (49)	0.535	35.4 ± 3.8 (78)	32.5 ± 2 (78)	0.409
EF, %	62.5 ± 2.6 (49)	62.2 ± 2.8 (49)	0.932	60.4 ± 2.3 (78)	59.9 ± 1.7 (78)	0,869
SV, ml (Simpson’s)	50.1 ± 3.1 (49)	53.1 ± 2.7 (49)	0.600	47.6 ± 3.2 (78)	47.9 ± 2 (78)	0.754
LVEDV, ml (3D)^b	82.5 ± 3.6 (30)	84.6 ± 2.8 (30)	0.553	82 ± 3.6 (42)	85.1 ± 3 (42)	0.187
LVESV, ml (3D)^b	32.1 ± 1.9 (30)	34.5 ± 1.7 (30)	0.266	35 ± 2.2 (42)	35.3 ± 2 (42)	0.857
SV, ml (3D)^b	50.3 ± 2.5 (30)	50.1 ± 2.5 (30)	0.952	46.9 ± 2.2 (42)	49.8 ± 2.1 (42)	0.221
EF (3D), %^b	61.1 ± 1.5 (30)	58.6 ± 2.1 (30)	0.356	57.4 ± 1.6 (42)	58.4 ± 1.6 (42)	0.869
LV–LS, %	− 13.2 ± 0.8 (41)	− 17.4 ± 0.7 (41)#	< 0.0001	− 12.5 ± 0.6 (58)	− 11.9 ± 0.5 (58)	0.298
LV S’, cm/s	10.5 ± 0.8 (31)	10.6 ± 0.8 (31)	0.581	10.2 ± 0.6 (65)	10.4 ± 0.6 (65)	0.036
Pericardial effusion	17/56 (30.4%)*	14/49 (28.6%)*	1.000	53/120 (44.2%)	39/78 (50%)	1.000

Data are expressed as mean ± standard error of means
A left ventricular late diastolic filling velocity with atrial contraction, ACP, acute cor pulmonale, E, left ventricular early diastolic peak velocity, E’, early diastolic tissue Doppler velocity, EF ejection fraction, LV–LS longitudinal strain of the left ventricle, IVA isovolumic acceleration, IVS interventricular septum, LVEDD left ventricular end diastolic diameter, LVEDV left ventricular end diastolic volume, LVESV left ventricular end systolic volume, LV s’ systolic tissue Doppler velocity measured at the lateral mitral annulus, PASP pulmonary artery systolic pressure, PASP/VTI_RVOT pulmonary artery systolic pressure to right ventricular outflow tract velocity time integral ratio, RVEDA/LVEDA right ventricular end diastolic area to left ventricular end diastolic area, RVEDV right ventricular end diastolic volume, RVEF right ventricular ejection fraction, RVESV right ventricular end systolic volume, RVFAC right ventricular fractional area change, RV–LS right ventricular free wall longitudinal strain, RV S’ systolic tissue Doppler velocity measured at the lateral tricuspid annulus, RV SV right ventricular stroke volume, SV stroke volume, TAPSE tricuspid annular plane systolic excursion, VAC_R right ventricular to pulmonary artery coupling, VTI_LVOT, left ventricular outflow tract velocity time integral, VTI_RVOT, right ventricular outflow tract velocity time integral
^aNumbers in parenthesis refer to the actual number of patients that the variable was measured
^b3D measurements

Back to article page