Iranian Heart Journal

Iranian Heart Journal

Utility of the Right Ventricular Early Inflow-Out Flow Index in the Assessment of Mortality in COVID-19

Document Type : Original Article

Authors
Atoosa Mostafavi
Seyed Abdolhossein Tabatabaei
Somayeh Zamani Fard
Fatemeh Majidi
Abbas Mohagheghi
Shahin Shirani
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: The coronavirus disease 2019 (COVID-19) outbreak continues to spread worldwide, hence the increasing attention to the predictors of mortality. However, there is no easy prognostic risk score to predict in-hospital mortality.
We aimed to assess the efficacy of the right ventricular early inflow-outflow index (RVEIO) as a predictor of early mortality in patients with thromboembolism. Additionally, we assessed acute respiratory distress syndrome, which is deemed a complication of COVID-19 and an etiology of acute cor pulmonale.
 
Methods: This single-center, observational cross-sectional study assessed laboratory data and electrocardiographic and echocardiographic findings of patients with a diagnosis of COVID-19 based on a positive polymerase chain reaction test and lung involvement exceeding 20% in the non-intensive care units of our hospital.
 
Results: The study population comprised 360 patients (mean age=54.46 y, 61.1% male). The mean RVEIO index was 3.40 ± 1.14, the mean right ventricular peak systolic myocardial velocity (RVsm) was 12.29 ± 3.81 cm/s, and the mean tricuspid annular plane systolic excursion (TAPSE) was 22.41 ± 4.97 cm. No significant difference was found in the RVEIO index between the patients who were discharged and those who expired (3.26 ± 1.25 vs 3.31 ± 1.29, respectively), nor was there a correlation between the RVEIO index and admission to the intensive care unit. The RVEIO index was not a predictor of RV dysfunction, as assessed by RVsm and TAPSE. Patients who suffered from myocardial infarction had a significantly higher RVEIO index.
 
Conclusions: None of the echocardiographic findings, including the RVEIO index, was an accurate predictor of RV dysfunction, mortality, and inflammation levels in our patients with COVID-19. Accordingly, they should not be relied upon for clinical decision-making and management. (Iranian Heart Journal 2021; 22(3): 104-114)
Keywords
COVID-19
Early inflow-outflow index
Right ventricle
Prognosis
Mortality
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Iranian Heart Journal
Volume 22, Issue 3
Summer 2021
Pages 104-114