gbel3pq

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?:abstract	BACKGROUND: Coronavirus disease 2019 (COVID-19) is a growing pandemic that confers augmented risk for right ventricular (RV) dysfunction and dilation; the prognostic utility of adverse RV remodeling in COVID-19 patients is uncertain. OBJECTIVES: The purpose of this study was to test whether adverse RV remodeling (dysfunction/dilation) predicts COVID-19 prognosis independent of clinical and biomarker risk stratification. METHODS: Consecutive COVID-19 inpatients undergoing clinical transthoracic echocardiography at 3 New York City hospitals were studied; images were analyzed by a central core laboratory blinded to clinical and biomarker data. RESULTS: In total, 510 patients (age 64 ± 14 years, 66% men) were studied; RV dilation and dysfunction were present in 35% and 15%, respectively. RV dysfunction increased stepwise in relation to RV chamber size (p = 0.007). During inpatient follow-up (median 20 days), 77% of patients had a study-related endpoint (death 32%, discharge 45%). RV dysfunction (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.49 to 4.43; p = 0.001) and dilation (HR: 1.43; 95% CI: 1.05 to 1.96; p = 0.02) each independently conferred mortality risk. Patients without adverse RV remodeling were more likely to survive to hospital discharge (HR: 1.39; 95% CI: 1.01 to 1.90; p = 0.041). RV indices provided additional risk stratification beyond biomarker strata; risk for death was greatest among patients with adverse RV remodeling and positive biomarkers and was lesser among patients with isolated biomarker elevations (p ≤ 0.001). In multivariate analysis, adverse RV remodeling conferred a >2-fold increase in mortality risk, which remained significant (p < 0.01) when controlling for age and biomarker elevations; the predictive value of adverse RV remodeling was similar irrespective of whether analyses were performed using troponin, D-dimer, or ferritin. CONCLUSIONS: Adverse RV remodeling predicts mortality in COVID-19 independent of standard clinical and biomarker-based assessment.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/9gbel3pq_hasAnnotation_C0012359> <https://research.tib.eu/covid-19/entity/9gbel3pq_hasAnnotation_C0242707>
?:creator	<https://research.tib.eu/covid-19/entity/Kim%2C_Jiwon%3B_Volodarskiy%2C_Alexander%3B_Sultana%2C_Razia%3B_Pollie%2C_Meridith_P.%3B_Yum%2C_Brian%3B_Nambiar%2C_Lakshmi%3B_Tafreshi%2C_Romina%3B_Mitlak%2C_Hannah_W.%3B_RoyChoudhury%2C_Arindam%3B_Horn%2C_Evelyn_M.%3B_Hriljac%2C_Ingrid%3B_Narula%2C_Nupoor%3B_Kim%2C_Sijun%3B_Ndhlovu%2C_Lishomwa%3B_Goyal%2C_Parag%3B_Safford%2C_Monika_M.%3B_Shaw%2C_Leslee%3B_Devereux%2C_Richard_B.%3B_Weinsaft%2C_Jonathan_W.>
?:doi	10.1016/j.jacc.2020.08.066
?:doi	<https://research.tib.eu/covid-19/entity/10.1016/j.jacc.2020.08.066>
?:journal	J_Am_Coll_Cardiol
?:license	no-cc
?:pdf_json_files	document_parses/pdf_json/8a1cb4bb9223d5c5a9328e447e64793f3ff417b7.json
?:pmc_json_files	document_parses/pmc_json/PMC7572068.xml.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7572068>
?:pmid	<https://research.tib.eu/covid-19/entity/33092732.0>
?:pmid	33092732.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/8a1cb4bb9223d5c5a9328e447e64793f3ff417b7>
?:source	Elsevier; Medline; PMC
?:title	Prognostic Utility of Right Ventricular Remodeling Over Conventional Risk Stratification in Patients With COVID-19
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-10-27

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Value

?:abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a growing pandemic that confers augmented risk for right ventricular (RV) dysfunction and dilation; the prognostic utility of adverse RV remodeling in COVID-19 patients is uncertain. OBJECTIVES: The purpose of this study was to test whether adverse RV remodeling (dysfunction/dilation) predicts COVID-19 prognosis independent of clinical and biomarker risk stratification. METHODS: Consecutive COVID-19 inpatients undergoing clinical transthoracic echocardiography at 3 New York City hospitals were studied; images were analyzed by a central core laboratory blinded to clinical and biomarker data. RESULTS: In total, 510 patients (age 64 ± 14 years, 66% men) were studied; RV dilation and dysfunction were present in 35% and 15%, respectively. RV dysfunction increased stepwise in relation to RV chamber size (p = 0.007). During inpatient follow-up (median 20 days), 77% of patients had a study-related endpoint (death 32%, discharge 45%). RV dysfunction (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.49 to 4.43; p = 0.001) and dilation (HR: 1.43; 95% CI: 1.05 to 1.96; p = 0.02) each independently conferred mortality risk. Patients without adverse RV remodeling were more likely to survive to hospital discharge (HR: 1.39; 95% CI: 1.01 to 1.90; p = 0.041). RV indices provided additional risk stratification beyond biomarker strata; risk for death was greatest among patients with adverse RV remodeling and positive biomarkers and was lesser among patients with isolated biomarker elevations (p ≤ 0.001). In multivariate analysis, adverse RV remodeling conferred a >2-fold increase in mortality risk, which remained significant (p < 0.01) when controlling for age and biomarker elevations; the predictive value of adverse RV remodeling was similar irrespective of whether analyses were performed using troponin, D-dimer, or ferritin. CONCLUSIONS: Adverse RV remodeling predicts mortality in COVID-19 independent of standard clinical and biomarker-based assessment.

is ?:annotates of