The association of radiologic right heart strain indices with the severity of pulmonary parenchymal involvement and prognosis in patients with COVID-19.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-01-01 Epub Date: 2024-09-20 DOI:10.34172/jcvtr.33094

Parsa Rouzrokh, Malihe Rezaee, Zahra Mohammadipour, Sasan Tavana, Isa Khaheshi, Ali Sheikhy, Taraneh Faghihi Langroudi

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引用次数: 0

Abstract

Introduction: It has been demonstrated that an increase in the diameter of the right ventricle or pulmonary artery in COVID-19 patients could be associated with the severity of lung involvement and may lead to unfavorable outcomes, particularly in the presence of pulmonary vascular diseases. This study investigated the relationship between these right heart strain features, the extent of lung involvement, and their prognostic values in patients without vascular comorbidities.

Methods: This study selected 154 consecutive patients with positive chest computed tomography (CT) findings and no evidence of concurrent pulmonary disease. Clinical characteristics and adverse outcomes in in-hospital settings were collected retrospectively. Diameters of cardiac ventricles and arteries, along with lung opacification scores, were obtained using CT pulmonary angiography (CTPA) findings, and the association of these variables was evaluated.

Results: An increase in pulmonary artery (PA) to ascending aorta (AO) diameter ratio and lung parenchymal damage were significantly and positively correlated (P=0.017), but increased right ventricle (RV) to left ventricle (LV) diameter ratio showed no association with the extent of chest opacification (P=0.098). Evaluating the prognostic ability of both ratios using logistic regression and receiver operating characteristic (ROC) analysis proved no significant class separation in regards to predicting adverse outcomes (PA/AO: OR:1.081, P Value:0.638, RV/LV: OR:1.098, P Value:0.344).

Conclusion: In COVID-19 patients without vascular comorbidities, a higher PA/AO diameter ratio was significantly associated with increased lung involvement severity on CT imaging but not with adverse in-hospital outcomes. Conversely, an increased RV/LV ratio on CTPA did not correlate significantly with adverse outcomes or the severity of parenchymal lung damage.

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放射学右心应变指数与 COVID-19 患者肺实质受累严重程度和预后的关系。

导言：有研究表明，COVID-19患者右心室或肺动脉直径的增大可能与肺部受累的严重程度有关，并可能导致不利的预后，尤其是在存在肺血管疾病的情况下。本研究调查了无血管合并症患者的这些右心应变特征、肺部受累程度及其预后价值之间的关系：该研究选择了 154 名胸部计算机断层扫描（CT）结果呈阳性且无并发肺部疾病证据的连续患者。研究回顾性地收集了患者的临床特征和院内不良预后。利用 CT 肺血管造影（CTPA）结果获得心室和动脉直径以及肺不张评分，并评估这些变量之间的关联：结果：肺动脉（PA）与升主动脉（AO）直径比值的增加与肺实质损伤呈显著正相关（P=0.017），但右心室（RV）与左心室（LV）直径比值的增加与胸部不透明程度没有关联（P=0.098）。使用逻辑回归和接收器操作特征（ROC）分析评估这两个比率的预后能力，结果表明在预测不良预后方面没有明显的分级（PA/AO：OR：1.081，P 值：0.638；RV/LV：OR：1.098，P 值：0.344）：在没有血管合并症的COVID-19患者中，PA/AO直径比值越大，CT成像显示的肺部受累严重程度越高，但与不良院内预后无关。相反，CTPA 上 RV/LV 比值的增加与不良预后或肺实质损伤的严重程度并无显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.