Serveur d'exploration sur la COVID en France

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Global evaluation of echocardiography in patients with COVID-19.

Identifieur interne : 000E92 ( Main/Exploration ); précédent : 000E91; suivant : 000E93

Global evaluation of echocardiography in patients with COVID-19.

Auteurs : Marc R. Dweck [Royaume-Uni] ; Anda Bularga [Royaume-Uni] ; Rebecca T. Hahn [États-Unis] ; Rong Bing [Royaume-Uni] ; Kuan Ken Lee [Royaume-Uni] ; Andrew R. Chapman [Royaume-Uni] ; Audrey White [Royaume-Uni] ; Giovanni Di Salvo [Italie] ; Leyla Elif Sade [Turquie] ; Keith Pearce [Royaume-Uni] ; David E. Newby [Royaume-Uni] ; Bogdan A. Popescu [Roumanie] ; Erwan Donal [France] ; Bernard Cosyns [Belgique] ; Thor Edvardsen [Norvège] ; Nicholas L. Mills [Royaume-Uni] ; Kristina Haugaa [Norvège]

Source :

RBID : pubmed:32556199

Descripteurs français

English descriptors

Abstract

AIMS

To describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography.

METHODS AND RESULTS

In a prospective international survey, we captured echocardiography findings in patients with presumed or confirmed COVID-19 between 3 and 20 April 2020. Patient characteristics, indications, findings, and impact of echocardiography on management were recorded. Multivariable logistic regression identified predictors of echocardiographic abnormalities. A total of 1216 patients [62 (52-71) years, 70% male] from 69 countries across six continents were included. Overall, 667 (55%) patients had an abnormal echocardiogram. Left and right ventricular abnormalities were reported in 479 (39%) and 397 (33%) patients, respectively, with evidence of new myocardial infarction in 36 (3%), myocarditis in 35 (3%), and takotsubo cardiomyopathy in 19 (2%). Severe cardiac disease (severe ventricular dysfunction or tamponade) was observed in 182 (15%) patients. In those without pre-existing cardiac disease (n = 901), the echocardiogram was abnormal in 46%, and 13% had severe disease. Independent predictors of left and right ventricular abnormalities were distinct, including elevated natriuretic peptides [adjusted odds ratio (OR) 2.96, 95% confidence interval (CI) 1.75-5.05) and cardiac troponin (OR 1.69, 95% CI 1.13-2.53) for the former, and severity of COVID-19 symptoms (OR 3.19, 95% CI 1.73-6.10) for the latter. Echocardiography changed management in 33% of patients.

CONCLUSION

In this global survey, cardiac abnormalities were observed in half of all COVID-19 patients undergoing echocardiography. Abnormalities were often unheralded or severe, and imaging changed management in one-third of patients.


DOI: 10.1093/ehjci/jeaa178
PubMed: 32556199
PubMed Central: PMC7337658


Affiliations:


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<nlm:affiliation>Centre for Cardiovascular Science, University of Edinburgh, UK.</nlm:affiliation>
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<name sortKey="Bularga, Anda" sort="Bularga, Anda" uniqKey="Bularga A" first="Anda" last="Bularga">Anda Bularga</name>
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<nlm:affiliation>Centre for Cardiovascular Science, University of Edinburgh, UK.</nlm:affiliation>
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<name sortKey="Hahn, Rebecca T" sort="Hahn, Rebecca T" uniqKey="Hahn R" first="Rebecca T" last="Hahn">Rebecca T. Hahn</name>
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<nlm:affiliation>Columbia University Irving Medical Center, NY, USA.</nlm:affiliation>
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<name sortKey="Salvo, Giovanni Di" sort="Salvo, Giovanni Di" uniqKey="Salvo G" first="Giovanni Di" last="Salvo">Giovanni Di Salvo</name>
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<nlm:affiliation>University Hospital Padua, Paediatric Cardiology, Padua, Italy.</nlm:affiliation>
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<name sortKey="Sade, Leyla Elif" sort="Sade, Leyla Elif" uniqKey="Sade L" first="Leyla Elif" last="Sade">Leyla Elif Sade</name>
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<name sortKey="Newby, David E" sort="Newby, David E" uniqKey="Newby D" first="David E" last="Newby">David E. Newby</name>
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<settlement type="city">Édimbourg</settlement>
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<name sortKey="Popescu, Bogdan A" sort="Popescu, Bogdan A" uniqKey="Popescu B" first="Bogdan A" last="Popescu">Bogdan A. Popescu</name>
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<nlm:affiliation>Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Bucharest, Romania.</nlm:affiliation>
<country xml:lang="fr">Roumanie</country>
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<name sortKey="Donal, Erwan" sort="Donal, Erwan" uniqKey="Donal E" first="Erwan" last="Donal">Erwan Donal</name>
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<nlm:affiliation>University of Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, Rennes, France.</nlm:affiliation>
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<wicri:regionArea>University of Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, Rennes</wicri:regionArea>
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<region type="region">Région Bretagne</region>
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<name sortKey="Cosyns, Bernard" sort="Cosyns, Bernard" uniqKey="Cosyns B" first="Bernard" last="Cosyns">Bernard Cosyns</name>
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<nlm:affiliation>Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel, Vrij Universiteit van Brussel, Brussels, Belgium.</nlm:affiliation>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel, Vrij Universiteit van Brussel, Brussels</wicri:regionArea>
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<settlement type="city">Bruxelles</settlement>
<region nuts="2">Région de Bruxelles-Capitale</region>
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<name sortKey="Edvardsen, Thor" sort="Edvardsen, Thor" uniqKey="Edvardsen T" first="Thor" last="Edvardsen">Thor Edvardsen</name>
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<nlm:affiliation>Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.</nlm:affiliation>
<country xml:lang="fr">Norvège</country>
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<nlm:affiliation>Faculty of Medicine, University of Oslo, Oslo, Norway.</nlm:affiliation>
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<name sortKey="Haugaa, Kristina" sort="Haugaa, Kristina" uniqKey="Haugaa K" first="Kristina" last="Haugaa">Kristina Haugaa</name>
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<title level="j">European heart journal cardiovascular Imaging</title>
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<term>Age Factors (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Cardiovascular Diseases (diagnostic imaging)</term>
<term>Cardiovascular Diseases (epidemiology)</term>
<term>Comorbidity (MeSH)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Cross-Sectional Studies (MeSH)</term>
<term>Echocardiography (methods)</term>
<term>Europe (MeSH)</term>
<term>Female (MeSH)</term>
<term>Heart Diseases (diagnostic imaging)</term>
<term>Heart Diseases (epidemiology)</term>
<term>Humans (MeSH)</term>
<term>Incidence (MeSH)</term>
<term>Internationality (MeSH)</term>
<term>Internet (MeSH)</term>
<term>Logistic Models (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Multivariate Analysis (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Predictive Value of Tests (MeSH)</term>
<term>Prognosis (MeSH)</term>
<term>Prospective Studies (MeSH)</term>
<term>Sex Factors (MeSH)</term>
</keywords>
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<term>Adulte d'âge moyen (MeSH)</term>
<term>Analyse multifactorielle (MeSH)</term>
<term>Cardiopathies (imagerie diagnostique)</term>
<term>Cardiopathies (épidémiologie)</term>
<term>Comorbidité (MeSH)</term>
<term>Europe (MeSH)</term>
<term>Facteurs sexuels (MeSH)</term>
<term>Facteurs âges (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Incidence (MeSH)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Internationalité (MeSH)</term>
<term>Internet (MeSH)</term>
<term>Maladies cardiovasculaires (imagerie diagnostique)</term>
<term>Maladies cardiovasculaires (épidémiologie)</term>
<term>Modèles logistiques (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (diagnostic)</term>
<term>Pneumopathie virale (épidémiologie)</term>
<term>Pronostic (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Valeur prédictive des tests (MeSH)</term>
<term>Échocardiographie (méthodes)</term>
<term>Études prospectives (MeSH)</term>
<term>Études transversales (MeSH)</term>
</keywords>
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<term>Europe</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr">
<term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en">
<term>Cardiovascular Diseases</term>
<term>Heart Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Cardiovascular Diseases</term>
<term>Coronavirus Infections</term>
<term>Heart Diseases</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr">
<term>Cardiopathies</term>
<term>Maladies cardiovasculaires</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Echocardiography</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr">
<term>Échocardiographie</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr">
<term>Cardiopathies</term>
<term>Infections à coronavirus</term>
<term>Maladies cardiovasculaires</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Age Factors</term>
<term>Aged</term>
<term>Comorbidity</term>
<term>Cross-Sectional Studies</term>
<term>Female</term>
<term>Humans</term>
<term>Incidence</term>
<term>Internationality</term>
<term>Internet</term>
<term>Logistic Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Multivariate Analysis</term>
<term>Pandemics</term>
<term>Predictive Value of Tests</term>
<term>Prognosis</term>
<term>Prospective Studies</term>
<term>Sex Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adulte d'âge moyen</term>
<term>Analyse multifactorielle</term>
<term>Comorbidité</term>
<term>Europe</term>
<term>Facteurs sexuels</term>
<term>Facteurs âges</term>
<term>Femelle</term>
<term>Humains</term>
<term>Incidence</term>
<term>Internationalité</term>
<term>Internet</term>
<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Pandémies</term>
<term>Pronostic</term>
<term>Sujet âgé</term>
<term>Valeur prédictive des tests</term>
<term>Études prospectives</term>
<term>Études transversales</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>AIMS</b>
</p>
<p>To describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS AND RESULTS</b>
</p>
<p>In a prospective international survey, we captured echocardiography findings in patients with presumed or confirmed COVID-19 between 3 and 20 April 2020. Patient characteristics, indications, findings, and impact of echocardiography on management were recorded. Multivariable logistic regression identified predictors of echocardiographic abnormalities. A total of 1216 patients [62 (52-71) years, 70% male] from 69 countries across six continents were included. Overall, 667 (55%) patients had an abnormal echocardiogram. Left and right ventricular abnormalities were reported in 479 (39%) and 397 (33%) patients, respectively, with evidence of new myocardial infarction in 36 (3%), myocarditis in 35 (3%), and takotsubo cardiomyopathy in 19 (2%). Severe cardiac disease (severe ventricular dysfunction or tamponade) was observed in 182 (15%) patients. In those without pre-existing cardiac disease (n = 901), the echocardiogram was abnormal in 46%, and 13% had severe disease. Independent predictors of left and right ventricular abnormalities were distinct, including elevated natriuretic peptides [adjusted odds ratio (OR) 2.96, 95% confidence interval (CI) 1.75-5.05) and cardiac troponin (OR 1.69, 95% CI 1.13-2.53) for the former, and severity of COVID-19 symptoms (OR 3.19, 95% CI 1.73-6.10) for the latter. Echocardiography changed management in 33% of patients.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>In this global survey, cardiac abnormalities were observed in half of all COVID-19 patients undergoing echocardiography. Abnormalities were often unheralded or severe, and imaging changed management in one-third of patients.</p>
</div>
</front>
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<Year>2020</Year>
<Month>09</Month>
<Day>09</Day>
</DateCompleted>
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<Year>2020</Year>
<Month>09</Month>
<Day>09</Day>
</DateRevised>
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<Journal>
<ISSN IssnType="Electronic">2047-2412</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>21</Volume>
<Issue>9</Issue>
<PubDate>
<Year>2020</Year>
<Month>09</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>European heart journal cardiovascular Imaging</Title>
<ISOAbbreviation>Eur Heart J Cardiovasc Imaging</ISOAbbreviation>
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<ArticleTitle>Global evaluation of echocardiography in patients with COVID-19.</ArticleTitle>
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</Pagination>
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<Abstract>
<AbstractText Label="AIMS">To describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography.</AbstractText>
<AbstractText Label="METHODS AND RESULTS">In a prospective international survey, we captured echocardiography findings in patients with presumed or confirmed COVID-19 between 3 and 20 April 2020. Patient characteristics, indications, findings, and impact of echocardiography on management were recorded. Multivariable logistic regression identified predictors of echocardiographic abnormalities. A total of 1216 patients [62 (52-71) years, 70% male] from 69 countries across six continents were included. Overall, 667 (55%) patients had an abnormal echocardiogram. Left and right ventricular abnormalities were reported in 479 (39%) and 397 (33%) patients, respectively, with evidence of new myocardial infarction in 36 (3%), myocarditis in 35 (3%), and takotsubo cardiomyopathy in 19 (2%). Severe cardiac disease (severe ventricular dysfunction or tamponade) was observed in 182 (15%) patients. In those without pre-existing cardiac disease (n = 901), the echocardiogram was abnormal in 46%, and 13% had severe disease. Independent predictors of left and right ventricular abnormalities were distinct, including elevated natriuretic peptides [adjusted odds ratio (OR) 2.96, 95% confidence interval (CI) 1.75-5.05) and cardiac troponin (OR 1.69, 95% CI 1.13-2.53) for the former, and severity of COVID-19 symptoms (OR 3.19, 95% CI 1.73-6.10) for the latter. Echocardiography changed management in 33% of patients.</AbstractText>
<AbstractText Label="CONCLUSION">In this global survey, cardiac abnormalities were observed in half of all COVID-19 patients undergoing echocardiography. Abnormalities were often unheralded or severe, and imaging changed management in one-third of patients.</AbstractText>
<CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.</CopyrightInformation>
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<LastName>Dweck</LastName>
<ForeName>Marc R</ForeName>
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</AffiliationInfo>
</Author>
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<LastName>Bularga</LastName>
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<Affiliation>Centre for Cardiovascular Science, University of Edinburgh, UK.</Affiliation>
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<LastName>Hahn</LastName>
<ForeName>Rebecca T</ForeName>
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<Affiliation>Columbia University Irving Medical Center, NY, USA.</Affiliation>
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<ForeName>Rong</ForeName>
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</AffiliationInfo>
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<Initials>B</Initials>
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<Affiliation>Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel, Vrij Universiteit van Brussel, Brussels, Belgium.</Affiliation>
</AffiliationInfo>
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<LastName>Edvardsen</LastName>
<ForeName>Thor</ForeName>
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<AffiliationInfo>
<Affiliation>Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Faculty of Medicine, University of Oslo, Oslo, Norway.</Affiliation>
</AffiliationInfo>
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<Affiliation>Faculty of Medicine, University of Oslo, Oslo, Norway.</Affiliation>
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<Grant>
<Acronym>BHF_</Acronym>
<Agency>British Heart Foundation</Agency>
<Country>United Kingdom</Country>
</Grant>
<Grant>
<Acronym>WT_</Acronym>
<Agency>Wellcome Trust</Agency>
<Country>United Kingdom</Country>
</Grant>
<Grant>
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<Agency>Medical Research Council</Agency>
<Country>United Kingdom</Country>
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