Evidence map›Paper›PMID 33242508›Full record

Observational studyInternational journal of cardiology2021

Right ventricular dysfunction in critically ill COVID-19 ARDS.

Caroline Bleakley, Suveer Singh, Benjamin Garfield, Marco Morosin, Elena Surkova, Ms Sundhiya Mandalia, Bernardo Dias, Emmanouil Androulakis, Laura C Price, Colm McCabe and 7 more

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 4 pooled it
8.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 4 syntheses or guidelines pooled it, 129 citations in OpenAlex.

  1. Pooled it
  2. Echocardiographic assessment of the right ventricle in COVID-19: a systematic review.The international journal of cardiovascular imaging · 2021
    Pooled it
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  4. Prevalence of abnormal cardiovascular magnetic resonance findings in recovered patients from COVID-19: a systematic review and meta-analysis.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021
    Pooled it
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11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 2 institutions in 1 country.

Caroline BleakleyDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.
Suveer SinghDepartment of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.
Benjamin GarfieldDepartment of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.
Marco MorosinDepartment of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.
Elena SurkovaDepartment of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Ms Sundhiya MandaliaDepartment of Medical Statistics, Imperial College, London, UK.
Bernardo DiasDepartment of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Emmanouil AndroulakisDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK.
Laura C PricePulmonary Hypertension Service, Royal Brompton Hospital, Sydney Street, London, UK.
Colm McCabePulmonary Hypertension Service, Royal Brompton Hospital, Sydney Street, London, UK.
Stephen John WortPulmonary Hypertension Service, Royal Brompton Hospital, Sydney Street, London, UK.
Cathy WestDepartment of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Wei LiDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Rajdeep KhattarDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Roxy SeniorDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Echocardiography, Royal Brompton Hospital, Sydney Street, London, UK.
Brijesh V PatelDepartment of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK.
Susanna PriceDepartment of Cardiology, Royal Brompton Hospital, Sydney Street, London, UK; Department of Adult Critical Care, Royal Brompton Hospital, Sydney Street, London, UK. Electronic address: s.price@rbht.nhs.uk.
Royal Brompton Hospital · GBImperial College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsComprehensive echocardiography assessment of right ventricular (RV) impairment has not been reported in critically ill patients with COVID-19. We detail the specific phenotype and clinical associations of RV impairment in COVID-19 acute respiratory distress syndrome (ARDS).

methodsTransthoracic echocardiography (TTE) measures of RV function were collected in critically unwell patients for associations with clinical, ventilatory and laboratory data.

resultsNinety patients (25.6% female), mean age 52.0 ± 10.8 years, veno-venous extracorporeal membrane oxygenation (VVECMO) (42.2%) were studied. A significantly higher proportion of patients were identified as having RV dysfunction by RV fractional area change (FAC) (72.0%,95% confidence interval (CI) 61.0-81.0) and RV velocity time integral (VTI) (86.4%, 95 CI 77.3-93.2) than by tricuspid annular plane systolic excursion (TAPSE) (23.8%, 95 CI 16.0-33.9), RVS' (11.9%, 95% CI 6.6-20.5) or RV free wall strain (FWS) (35.3%, 95% CI 23.6-49.0). RV VTI correlated strongly with RV FAC (p ≤ 0.01). Multivariate regression demonstrated independent associations of RV FAC with NTpro-BNP and PVR. RV-PA coupling correlated with PVR (univariate p < 0.01), as well as RVEDAi (p < 0.01), and RVESAi (p < 0.01), and was associated with P/F ratio (p 0.026), PEEP (p 0.025), and ALT (p 0.028).

conclusionsSevere COVID-19 ARDS is associated with a specific phenotype of RV radial impairment with sparing of longitudinal function. Clinicians should avoid interpretation of RV health purely on long-axis parameters in these patients. RV-PA coupling potentially provides important additional information above standard measures of RV performance in this cohort.

Indexed as

Critical IllnessAdultCohort StudiesCOVID-19EchocardiographyFemaleHumansMaleMiddle AgedRetrospective StudiesVentricular Dysfunction, RightAcute respiratory distress syndromeCOVID-19Critical careEchocardiographyRight ventricle

Identifiers

PMID33242508
PMCPMC7681038
OpenAlexW3108304840

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.