In a new study, researchers found that right ventricular dilation is linked to high death risk among patients hospitalized with COVID-19.
The research was conducted by a team at Mount Sinai in New York City.
Right ventricular dilation happens when the muscle on the right side of your heart becomes thickened and enlarged.
It is usually caused by a problem in the lungs, such as pulmonary arterial hypertension.
The team examined patients hospitalized due to COVID-19 who underwent clinically indicated echocardiograms from March 26 to April 22, 2020.
They focused on the associations between clinical and echocardiographic variables and mortality.
The researchers found that at the time of echocardiographic examination, 31 patients were intubated and mechanically ventilated.
Thirty-two patients (31%) had right ventricular dilation. Patients with right ventricular dilation were more likely to have renal dysfunction than those without right ventricular dilation.
But there were no differences found in the prevalence of major comorbidities, laboratory markers of inflammation, or heart attack.
Patients with right ventricular enlargement had a higher risk of right ventricular hypokinesis and moderate or severe tricuspid regurgitation (i.e. pressure can rise in your right ventricle due to blood flowing backward into the right atrium and less blood flowing forward through the right ventricle and into the lungs.)
Five of 10 patients with right ventricular enlargement who underwent computed tomography angiography of the chest had evidence of pulmonary embolism.
During the study period, 21 patients died: 13 and eight (41% and 11%) patients with and without right ventricular dilation, respectively.
The right ventricular enlargement was the only variable significantly associated with mortality in a multivariable analysis.
This study provides important evidence associating right heart strain with bad health outcomes in hospitalized patients with COVID-19 infection.
The lead author of the study is Edgar Argulian, M.D., M.P.H. from the Icahn School of Medicine.
The study is published in JACC: Cardiovascular Imaging.
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