Abnormalities were diverse, with some patients exhibiting multiple abnormalities. 26.3 percent had right ventricular dysfunction (which can be associated with pulmonary embolism and severe respiratory failure), 23.7 percent had regional left ventricular wall motion abnormalities (which can be associated with heart attacks), 18.4 percent had diffuse left ventricular dysfunction (which can be associated with heart failure/myocarditis), 13.2 percent had grade II or III diastolic dysfunction (a condition leading to stiffer cardiac chambers), and 7.2 percent had pericardial effusions (extra fluid around the heart that causes abnormal pumping of the heart).
The study went on to look at in-hospital mortality and troponin elevation. It shows that troponin elevation was 5.2 percent among patients who did not have heart injury, compared to 18.6 percent for patients with myocardial injury but without echocardiographic abnormalities, and 31.7 percent for patients with myocardial injury who also had echocardiographic abnormalities. Researchers adjusted for other major complications from COVID-19 including shock, acute respiratory distress syndrome, and renal failure.
"Our study shows that an echocardiogram performed with appropriate personal protection considerations is a useful and important tool in early identification of patients at greater risk for COVID-19-related cardiac injury, who may benefit from a more aggressive therapeutic approach earlier in their hospitalization," says corresponding author Martin Goldman, MD, Arthur M. and Hilda A. Master Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. "Additionally, because this is a new disease with lingering symptoms, we plan on following these patients closely using imaging to evaluate the evolution and hopefully resolution of these cardiac issues."
"Echocardiograms have shown to be invaluable in providing critical information on patients who present with multiple cardiac complaints. Echocardiography is the only imaging modality that can be taken to the bedside and safely used for patients including those on ventilators," says Lori Croft, MD, Associate Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai and Director of the Echocardiography Laboratory at The Mount Sinai Hospital. "Our findings will help guide care of Covid-19 patients during a critical time."
