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Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Am+Soc+Echocardiogr 2020 ; 33 (10): 1278-84 Nephropedia Template TP
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Indications for and Findings on Transthoracic Echocardiography in COVID-19 #MMPMID32782131
Jain SS; Liu Q; Raikhelkar J; Fried J; Elias P; Poterucha TJ; DeFilippis EM; Rosenblum H; Wang EY; Redfors B; Clerkin K; Griffin JM; Wan EY; Abdalla M; Bello NA; Hahn RT; Shimbo D; Weiner SD; Kirtane AJ; Kodali SK; Burkhoff D; Rabbani LE; Schwartz A; Leon MB; Homma S; Di Tullio MR; Sayer G; Uriel N; Anstey DE
J Am Soc Echocardiogr 2020[Oct]; 33 (10): 1278-84 PMID32782131show ga
Background: Despite growing evidence of cardiovascular complications associated with coronavirus disease 2019 (COVID-19), there are few data regarding the performance of transthoracic echocardiography (TTE) and the spectrum of echocardiographic findings in this disease. Methods: A retrospective analysis was performed among adult patients admitted to a quaternary care center in New York City between March 1 and April 3, 2020. Patients were included if they underwent TTE during the hospitalization after a known positive diagnosis for COVID-19. Demographic and clinical data were obtained using chart abstraction from the electronic medical record. Results: Of 749 patients, 72 (9.6%) underwent TTE following positive results on severe acute respiratory syndrome coronavirus-2 polymerase chain reaction testing. The most common clinical indications for TTE were concern for a major acute cardiovascular event (45.8%) and hemodynamic instability (29.2%). Although most patients had preserved biventricular function, 34.7% were found to have left ventricular ejection fractions ? 50%, and 13.9% had at least moderately reduced right ventricular function. Four patients had wall motion abnormalities suggestive of stress-induced cardiomyopathy. Using Spearman rank correlation, there was an inverse relationship between high-sensitivity troponin T and left ventricular ejection fraction (? = ?0.34, P = .006). Among 20 patients with prior echocardiograms, only two (10%) had new reductions in LVEF of >10%. Clinical management was changed in eight individuals (24.2%) in whom TTE was ordered for concern for acute major cardiovascular events and three (14.3%) in whom TTE was ordered for hemodynamic evaluation. Conclusions: This study describes the clinical indications for use and diagnostic performance of TTE, as well as findings seen on TTE, in hospitalized patients with COVID-19. In appropriately selected patients, TTE can be an invaluable tool for guiding COVID-19 clinical management.