COVID-19 ile Hastaneye Yatırılmayan Hastalarda Yüksek Vücut Kitle İndeksi ve Diyastolik Disfonksiyon İlişkisi: Bir COVID-19 Sonrası Ekokardiyografi Çalışması

Abstract

Amaç: Çalışmalar, metabolik olarak sağlıklı bireylerde vücut kitle indeksi (VKİ) ile diyastolik fonksiyon arasında bir ilişki olduğunu bildirmektedir. Metabolik olarak sağlıklı olup hastaneye yatırılmadan COVID-19'dan iyileşen ve sonrasında efor dispnesi gelişenlerin VKİ ile diyastolik disfonksiyon (DD) arasındaki ilişki henüz yeterince araştırılmamıştır. Bu çalışmada, ejeksiyon fraksiyonu korunmuş komplike olmayan bir grupta VKİ ile diyastolik fonksiyon arasındaki ilişkiyi karakterize etmeyi amaçladık. Materyal ve Metod: Çalışmaya 50 (17 erkek ve 33 kadın) hasta (HG) ve 50 (20 erkek ve 30 kadın) sağlıklı kontrol deneği (KG) dahil edildi. Tüm hastalara transtorasik ekokardiyogram uygulandı. Bulgular: Gruplar arasında yaş (p=0,101), cinsiyet (p=0,534) ve VKİ (p=0,070) açısından anlamlı fark yoktu. HG'de C-reaktif protein (CRP) (p=0,005) ve D-dimer (p=0,009) anlamlı olarak daha yüksekti. Grade 1 DD, HG'de anlamlı olarak daha yüksekti (p<0,001). HG'de yaşın etkisi kontrol edildiğinde, VKİ ile E/A oranı arasında anlamlı negatif korelasyon bulunurken (r=-0,452; p=0,001) KG'de bu anlamlılık tespit edilmedi (r=0,122; p=0,404). DD'nin saptanması için VKİ’nin ROC eğrisi altındaki alan 0,806 idi (p<0.001;% 95 CI (0.716-0.896)). VKİ için optimal kesme puanı 28,91’di ve DD tanısı için duyarlılığı ve özgüllüğü sırasıyla %39,3 ve %93,1’di. İkili lojistik regresyon analizine göre, VKİ'nin DD tanısına ilişkin duyarlılığı %50,0 ve özgüllüğü %88,9’di. Sonuç: Kardiyak fonksiyondaki bu erken anormallikler, daha yüksek VKİ'nin neden olduğu artmış kardiyopulmoner morbidite ile ilişkili DD'yi açıklamak için önemli sonuçlara sahip olabilir.

Keywords

• Vücut kitle indeksi
• diyastolik fonksiyon
• transtorasik ekokardiyografi
• COVID-19

Association of Higher Body Mass Index and Diastolic Dysfunction in Patients Non-Hospitalized with COVID-19: A Post-COVID-19 Echocardiography Study

Abstract

Background: The studies reported an association between body mass index (BMI) and diastolic function in metabolically healthy individuals. The relationship between the BMI and diastolic dysfunction (DD) of those who are metabolically healthy who recovered from COVID-19 without hospitalization and who have effort dyspnea has not been adequately studied yet. In this study, we aimed to characterize the association between BMI and diastolic function in an uncomplicated group with preserved ejection fraction. Materials and Methods: The study included 50 (17 males and 33 females) patients (PG) and 50 (20 males and 30 females) healthy control subjects (CG). Transthoracic echocardiogram was performed in all patients. Results: There was no significant difference between the groups in terms of age (p=0.101), gender (p=0.534), and BMI (p=0.070). C-reactive protein (CRP) (p=0.005) and D-dimer (p=0.009) were significantly higher in the PG. Grade 1 DD was significantly higher in PG (p<0.001). When controlling for the effect of age in the PG, a significant negative correlation was found between BMI and E/A ratio (r=-0.452; p=0.001), while this significance was not detected in the CG (r=0.122; p=0.404). The area under the ROC curve of BMI for the detection of DD was 0.806 (p<0.001; 95% CI (0.716-0.896)). The optimal cut-off score for BMI was 28.91, and its sensitivity and specificity for the diagnosis of DD were 39.3% and 93.1%, respectively. According to the binary logistic regression analysis, the sensitivity of BMI related to the diagnosis of DD was 50.0% and the specificity was 88.9%. Conclusions: These early abnormalities in cardiac function may have important implications for explaining the DD that is associated with increased cardiopulmonary morbidity caused by higher BMI.

Keywords

• Body mass index
• diastolic function
• transthoracic echocardiography
• COVID-19

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