cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2023.5.n1806cardio-1806Research ArticleРЕДАКЦИОННАЯ СТАТЬЯEDITORIALОсобенности эхокардиографического исследования у больных с COVID – 19Features of echocardiographic examination in patients with COVID-19https://orcid.org/0000-0002-6252-0322ГолуховаЕ. З.GolukhovaE. Z.

академик РАН, доктор медицинских наук, профессор, директор НМИЦ ССХ имени А.Н. Бакулева МЗ РФ, заведующий кафедрой кардиологии и функциональной диагностики с курсом детской кардиологии Института подготовки кадров высшей квалификации профессионального образования

 Москва, Россия

Academic of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Head of A.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation

Moscow, Russia

ezgolukhova@bakulev.ruhttps://orcid.org/0000-0001-7935-7093СливневаИ. В.SlivnevaI. V.

кандидат медицинских наук, заведующий отделением кардиоваскулярной и коморбидной патологии НМИЦ ССХ им. А.Н. Бакулева Минздрава России,  доцент кафедры кардиологии и функциональной диагностики с курсом детской кардиологии Института подготовки кадров высшей квалификации профессионального образования

Москва, Россия

Ph., Head of the Department of Cardiovascular and Comorbid Pathology, A.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation.  

Moscow, Russia

slivneva@mail.ruhttps://orcid.org/0000-0002-7444-9930МамалыгаМ. Л.MamalygaM. L.

 доктор медицинских наук, старший научный сотрудник отделения хирургического лечения ишемической болезни сердца НМИЦ ССХ имени А.Н. Бакулева МЗ РФ

Москва, Россия

Doctor of Medical Sciences, Senior researcher of the Department of surgical treatment of ischemic heart disease, A.N. Bakulev National Medical Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation.

Moscow, Russia

mamalyga83@mail.ruhttps://orcid.org/0000-0002-9725-7528АлёхинМ. Н.AlekhinM. N.

д.м.н., заслуженный врач РФ, заведующий отделением функциональной диагностики ФГБУ "Центральная клиническая больница с поликлиникой" Управления делами Президента РФ, профессор кафедры терапии, кардиологии и функциональной диагностики с курсом нефрологии ФГБУ ДПО "Центральная государственная медицинская академия" Управления делами Президента РФ

Москва, Россия

Doctor of Medical Sciences, Honored Physician of the Russian Federation, Head of the Functional Diagnostics Department of the Central Clinical Hospital with Polyclinic, Russian Presidential Administration. Professor of the Therapy, Cardiology and Functional Diagnostics Department with a Course of Nephrology at the Central State Medical Academy of the Russian Presidential Administratio

Moscow, Russia

amn@mail.ruФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава РФРоссияBakulev National Medical Research Center of Cardiovascular SurgeryRussian FederationФГБУ «Центральная клиническая больница с поликлиникой» Управления делами ПрезидентаРоссияCentral Clinical Hospital of the Administrative Directorate of the President of the Russian FederationRussian Federation202331052023635311Copyright © Kardiomag, 20232023KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1806

Новая коронавирусная инфекция стала одной из актуальных проблем здравоохранения ХХI века. Возникающие при этом расстройства часто приводят к формированию кардиопульмональной патологии, требующей создания новой парадигмы в диагностике и лечении. Исследования, проведенные в период пандемии, показали важную роль эхокардиографии (ЭхоКГ) в диагностике дисфункции правого желудочка (ПЖ) у пациентов с дыхательной недостаточностью при COVID-19. С этой целью проведен анализ показателей ЭхоКГ, обладающих высокой прогностической ценностью. На основании полученных данных можно полагать, что при ЭхоКГ дополнительный акцент должен быть сделан на изучении размеров правых отделов сердца, сократительной функции ПЖ и систолического давления в легочной артерии (ЛА) как наиболее чувствительных показателей постнагрузки ПЖ и косвенных маркеров тяжести заболевания легких. Для оценки систолической функции ПЖ можно рекомендовать RV FAC как наиболее информативный показатель. Кроме того, установлено, что продольный стрейн ПЖ имеет дополнительное значение в ранней идентификации признаков систолической дисфункции и стратификации риска у пациентов с COVID-19. Помимо эффективности и воспроизводимости метода, важным преимуществом ЭхоКГ является ее доступность, возможность сохранять изображения для дистанционной интерпретации другими специалистами, отслеживание изменений морфофункциональных параметров сердца. Таким образом, проведенный анализ мировой литературы позволяет полагать, что ЭхоКГ играет важную роль в прогнозировании тяжелых кардиопульмональных нарушений, своевременном выборе стратегии лечения пациентов с COVID-19, поэтому должна служить дополнительным методом клинической оценки, особенно у лиц с умеренной или тяжелой формой заболевания.

 

Novel coronavirus infection has become one of urgent health problems of the 21st century. The associated disorders often result in the development of cardiopulmonary pathology, which requires creation of a new paradigm in diagnosis and treatment. Studies performed during the pandemic have demonstrated an important role of echocardiography (EchoCG) in diagnosis of right ventricular (RV) dysfunction in patients with respiratory insufficiency in COVID-19. The analysis of EchoCG parameters with a high prognostic value showed that in EchoCG, a special attention should be paid to right heart dimensions, RV contractility, and pulmonary artery (PA) systolic pressure, which are the most sensitive indexes of RV afterload and indirect markers of pulmonary disease severity. RV FAC can be recommended for evaluation of the RV systolic function as the most informative variable. Also, it was demonstrated that the RV longitudinal strain has an additional significance for early identification of signs of systolic dysfunction and risk stratification in patients with COVID-19. In addition to the effectiveness and reproducibility of this method, an important advantage of EchoCG is its availability, possibility of saving images for remote interpretation by other specialists, and tracking changes in morphological and functional parameters of the heart. Thus, the analysis of international literature suggests that EchoCG plays an important role in prediction of severe cardiopulmonary disorders and timely selection of the treatment for patients with COVID-19. For these reasons, EchoCG should serve as an additional method of clinical evaluation, particularly in persons with moderate or severe disease.

Эхокардиографиядисфункция правого желудочкаCOVID-19предиктор неблагоприятного исходапродольный стрейн правого желудочкаEchocardiographyright ventricular dysfunctionCOVID-19predictor of adverse outcomeright ventricular longitudinal strainКонфликт интересов не заявленNo conflict of interest is reported.ReferencesHuang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497–506. DOI: 10.1016/S0140-6736(20)30183-5Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497–506. DOI: 10.1016/S0140-6736(20)30183-5Голухова Е.З., Сливнева И.В., Рыбка М.М., Мамалыга М.Л., Алехин М.Н., Ключников И.В. и др. Структурно-функциональные изменения правого желудочка при COVID-19 по данным эхокардиографии. Креативная кардиология. 2020;14(3):206–23. DOI: 10.24022/1997-3187-2020-14-3-206-223Golukhova E.Z., Slivneva I.V., Rybka M.M., Mamalyga M.L., Alekhin M.N., Klyuchnikov I.V. et al. Structural and functional сhanges of the right ventricle in COVID-19 according to echocardiography. Creative Cardiology. 2020;14(3):206–23. DOI: 10.24022/1997-3187-2020-14-3-206-223Capotosto L, Nguyen BL, Ciardi MR, Mastroianni C, Vitarelli A. Heart, COVID‐19, and echocardiography. Echocardiography. 2020;37(9):1454–64. DOI: 10.1111/echo.14834Capotosto L, Nguyen BL, Ciardi MR, Mastroianni C, Vitarelli A. Heart, COVID‐19, and echocardiography. Echocardiography. 2020;37(9):1454–64. DOI: 10.1111/echo.14834Picard MH, Weiner RB. Echocardiography in the Time of COVID-19. Journal of the American Society of Echocardiography. 2020;33(6):674–5. DOI: 10.1016/j.echo.2020.04.011Picard MH, Weiner RB. Echocardiography in the Time of COVID-19. Journal of the American Society of Echocardiography. 2020;33(6):674–5. DOI: 10.1016/j.echo.2020.04.011Máca J, Jor O, Holub M, Sklienka P, Burša F, Burda M et al. Past and Present ARDS Mortality Rates: A Systematic Review. Respiratory Care. 2017;62(1):113–22. DOI: 10.4187/respcare.04716Máca J, Jor O, Holub M, Sklienka P, Burša F, Burda M et al. Past and Present ARDS Mortality Rates: A Systematic Review. Respiratory Care. 2017;62(1):113–22. DOI: 10.4187/respcare.04716Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Internal Medicine. 2020;180(10):1345–55. DOI: 10.1001/jamainternmed.2020.3539Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Internal Medicine. 2020;180(10):1345–55. DOI: 10.1001/jamainternmed.2020.3539Giustino G, Croft LB, Stefanini GG, Bragato R, Silbiger JJ, Vicenzi M et al. Characterization of Myocardial Injury in Patients With COVID-19. Journal of the American College of Cardiology. 2020;76(18):2043–55. DOI: 10.1016/j.jacc.2020.08.069Giustino G, Croft LB, Stefanini GG, Bragato R, Silbiger JJ, Vicenzi M et al. Characterization of Myocardial Injury in Patients With COVID-19. Journal of the American College of Cardiology. 2020;76(18):2043–55. DOI: 10.1016/j.jacc.2020.08.069Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395(10229):1054–62. DOI: 10.1016/S0140-6736(20)30566-3Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395(10229):1054–62. DOI: 10.1016/S0140-6736(20)30566-3Linschoten M, Peters S, Van Smeden M, Jewbali LS, Schaap J, Siebelink H-M et al. Cardiac complications in patients hospitalised with COVID-19. European Heart Journal. Acute Cardiovascular Care. 2020;9(8):817–23. DOI: 10.1177/2048872620974605Linschoten M, Peters S, Van Smeden M, Jewbali LS, Schaap J, Siebelink H-M et al. Cardiac complications in patients hospitalised with COVID-19. European Heart Journal. Acute Cardiovascular Care. 2020;9(8):817–23. DOI: 10.1177/2048872620974605Li Y, Li H, Zhu S, Xie Y, Wang B, He L et al. Prognostic Value of Right Ventricular Longitudinal Strain in Patients With COVID-19. JACC Cardiovascular Imaging. 2020;13(11):2287–99. DOI: 10.1016/j.jcmg.2020.04.014Li Y, Li H, Zhu S, Xie Y, Wang B, He L et al. Prognostic Value of Right Ventricular Longitudinal Strain in Patients With COVID-19. JACC Cardiovascular Imaging. 2020;13(11):2287–99. DOI: 10.1016/j.jcmg.2020.04.014Bhatia HS, Bui QM, King K, DeMaria A, Daniels LB. Subclinical left ventricular dysfunction in COVID-19. IJC Heart & Vasculature. 2021;34:100770. DOI: 10.1016/j.ijcha.2021.100770Bhatia HS, Bui QM, King K, DeMaria A, Daniels LB. Subclinical left ventricular dysfunction in COVID-19. IJC Heart & Vasculature. 2021;34:100770. DOI: 10.1016/j.ijcha.2021.100770Hollenberg SM, Safi L, Parrillo JE, Fata M, Klinkhammer B, Gayed N et al. Hemodynamic Profiles of Shock in Patients With COVID-19. The American Journal of Cardiology. 2021;153:135–9. DOI: 10.1016/j.amjcard.2021.05.029Hollenberg SM, Safi L, Parrillo JE, Fata M, Klinkhammer B, Gayed N et al. Hemodynamic Profiles of Shock in Patients With COVID-19. The American Journal of Cardiology. 2021;153:135–9. DOI: 10.1016/j.amjcard.2021.05.029Alvarez-Garcia J, Lee S, Gupta A, Cagliostro M, Joshi AA, Rivas-Lasarte M et al. Prognostic Impact of Prior Heart Failure in Patients Hospitalized With COVID-19. Journal of the American College of Cardiology. 2020;76(20):2334–48. DOI: 10.1016/j.jacc.2020.09.549Alvarez-Garcia J, Lee S, Gupta A, Cagliostro M, Joshi AA, Rivas-Lasarte M et al. Prognostic Impact of Prior Heart Failure in Patients Hospitalized With COVID-19. Journal of the American College of Cardiology. 2020;76(20):2334–48. DOI: 10.1016/j.jacc.2020.09.549Kirkpatrick JN, Mitchell C, Taub C, Kort S, Hung J, Swaminathan M. ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak. Journal of the American College of Cardiology. 2020;75(24):3078–84. DOI: 10.1016/j.jacc.2020.04.002Kirkpatrick JN, Mitchell C, Taub C, Kort S, Hung J, Swaminathan M. ASE Statement on Protection of Patients and Echocardiography Service Providers During the 2019 Novel Coronavirus Outbreak. Journal of the American College of Cardiology. 2020;75(24):3078–84. DOI: 10.1016/j.jacc.2020.04.002Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. European Heart Journal - Cardiovascular Imaging. 2020;21(6):592–8. DOI: 10.1093/ehjci/jeaa072Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E et al. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. European Heart Journal - Cardiovascular Imaging. 2020;21(6):592–8. DOI: 10.1093/ehjci/jeaa072Cameli M, Pastore MC, Soliman Aboumarie H, Mandoli GE, D’Ascenzi F, Cameli P et al. Usefulness of echocardiography to detect cardiac involvement in COVID‐19 patients. Echocardiography. 2020;37(8):1278–86. DOI: 10.1111/echo.14779Cameli M, Pastore MC, Soliman Aboumarie H, Mandoli GE, D’Ascenzi F, Cameli P et al. Usefulness of echocardiography to detect cardiac involvement in COVID‐19 patients. Echocardiography. 2020;37(8):1278–86. DOI: 10.1111/echo.14779Cresti A, Barchitta A, Barbieri A, Monte IP, Trocino G, Ciampi Q et al. Echocardiography and Multimodality Cardiac Imaging in COVID-19 Patients. Journal of Cardiovascular Echography. 2020;30(Suppl 2):S18–24. DOI: 10.4103/jcecho.jcecho_58_20Cresti A, Barchitta A, Barbieri A, Monte IP, Trocino G, Ciampi Q et al. Echocardiography and Multimodality Cardiac Imaging in COVID-19 Patients. Journal of Cardiovascular Echography. 2020;30(Suppl 2):S18–24. DOI: 10.4103/jcecho.jcecho_58_20Zhang L, Wang B, Zhou J, Kirkpatrick J, Xie M, Johri AM. Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography, and Critical Care Echocardiography. Journal of the American Society of Echocardiography. 2020;33(6):676–82. DOI: 10.1016/j.echo.2020.04.004Zhang L, Wang B, Zhou J, Kirkpatrick J, Xie M, Johri AM. Bedside Focused Cardiac Ultrasound in COVID-19 from the Wuhan Epicenter: The Role of Cardiac Point-of-Care Ultrasound, Limited Transthoracic Echocardiography, and Critical Care Echocardiography. Journal of the American Society of Echocardiography. 2020;33(6):676–82. DOI: 10.1016/j.echo.2020.04.004Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiology. 2020;5(7):802–10. DOI: 10.1001/jamacardio.2020.0950Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiology. 2020;5(7):802–10. DOI: 10.1001/jamacardio.2020.0950Davlouros PA. The right ventricle in congenital heart disease. Heart.2006;92(Suppl 1):i27–38. DOI: 10.1136/hrt.2005.077438Davlouros PA. The right ventricle in congenital heart disease. Heart.2006;92(Suppl 1):i27–38. DOI: 10.1136/hrt.2005.077438Haddad F, Doyle R, Murphy DJ, Hunt SA. Right Ventricular Function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure. Circulation. 2008;117(13):1717–31. DOI: 10.1161/CIRCULATIONAHA.107.653584Haddad F, Doyle R, Murphy DJ, Hunt SA. Right Ventricular Function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure. Circulation. 2008;117(13):1717–31. DOI: 10.1161/CIRCULATIONAHA.107.653584Murninkas D, Alba AC, Delgado D, McDonald M, Billia F, Chan WS et al. Right ventricular function and prognosis in stable heart failure patients. Journal of Cardiac Failure. 2014;20(5):343–9. DOI: 10.1016/j.cardfail.2014.01.018Murninkas D, Alba AC, Delgado D, McDonald M, Billia F, Chan WS et al. Right ventricular function and prognosis in stable heart failure patients. Journal of Cardiac Failure. 2014;20(5):343–9. DOI: 10.1016/j.cardfail.2014.01.018Голухова Е.З., Сливнева И.В., Рыбка М.М., Мамалыга М.Л., Марапов Д.И., Ключников И.В. и др. Систолическая дисфункция правого желудочка как предиктор неблагоприятного исхода у пациентов с COVID-19. Кардиология. 2020;60(11):16–29. DOI: 10.18087/cardio.2020.11.n1303Golukhova E.Z., Slivneva I.V., Rybka M.M., Mamalyga M.L., Marapov D.I., Klyuchnikov I.V. et al. Right ventricular systolic dysfunction as a predictor of adverse outcome in patients with COVID-19. Kardiologiia. 2020;60(11):16–29. DOI: 10.18087/cardio.2020.11.n1303Hanley B, Jensen M, Osborn M. Emerging spectrum of COVID-19-related cardiopulmonary pathology in adults. Diagnostic Histopathology. 2021;27(8):317–24. DOI: 10.1016/j.mpdhp.2021.05.002Hanley B, Jensen M, Osborn M. Emerging spectrum of COVID-19-related cardiopulmonary pathology in adults. Diagnostic Histopathology. 2021;27(8):317–24. DOI: 10.1016/j.mpdhp.2021.05.002Buja LM, Zhao B, McDonald M, Ottaviani G, Wolf DA. Commentary on the spectrum of cardiopulmonary pathology in COVID-19. Cardiovascular Pathology. 2021;53:107339. DOI: 10.1016/j.carpath.2021.107339Buja LM, Zhao B, McDonald M, Ottaviani G, Wolf DA. Commentary on the spectrum of cardiopulmonary pathology in COVID-19. Cardiovascular Pathology. 2021;53:107339. DOI: 10.1016/j.carpath.2021.107339Argulian E, Sud K, Vogel B, Bohra C, Garg VP, Talebi S et al. Right Ventricular Dilation in Hospitalized Patients With COVID-19 Infection. JACC: Cardiovascular Imaging. 2020;13(11):2459–61. DOI: 10.1016/j.jcmg.2020.05.010Argulian E, Sud K, Vogel B, Bohra C, Garg VP, Talebi S et al. Right Ventricular Dilation in Hospitalized Patients With COVID-19 Infection. JACC: Cardiovascular Imaging. 2020;13(11):2459–61. DOI: 10.1016/j.jcmg.2020.05.010Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography. Journal of the American Society of Echocardiography. 2010;23(7):685–713. DOI: 10.1016/j.echo.2010.05.010Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography. Journal of the American Society of Echocardiography. 2010;23(7):685–713. DOI: 10.1016/j.echo.2010.05.010Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2015;28(1):1-39.e14. DOI: 10.1016/j.echo.2014.10.003Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2015;28(1):1-39.e14. DOI: 10.1016/j.echo.2014.10.003Martha JW, Pranata R, Wibowo A, Lim MA. Tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography and mortality in COVID-19: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2021;105:351–6. DOI: 10.1016/j.ijid.2021.02.029Martha JW, Pranata R, Wibowo A, Lim MA. Tricuspid annular plane systolic excursion (TAPSE) measured by echocardiography andDeng Q, Hu B, Zhang Y, Wang H, Zhou X, Hu W et al. Suspected myocardial injury in patients with COVID-19: Evidence from front-line clinical observation in Wuhan, China. International Journal of Cardiology. 2020;311:116–21. DOI: 10.1016/j.ijcard.2020.03.087mortality in COVID-19: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2021;105:351–6. DOI: 10.1016/j.ijid.2021.02.029Jurcut R, Giusca S, La Gerche A, Vasile S, Ginghina C, Voigt J-U. The echocardiographic assessment of the right ventricle: what to do in 2010? European Journal of Echocardiography. 2010;11(2):81–96. DOI: 10.1093/ejechocard/jep234Deng Q, Hu B, Zhang Y, Wang H, Zhou X, Hu W et al. Suspected myocardial injury in patients with COVID-19: Evidence from front-line clinical observation in Wuhan, China. International Journal of Cardiology. 2020;311:116–21. DOI: 10.1016/j.ijcard.2020.03.087Agasthi P, Chao C, Siegel RJ, Pujari SH, Mookadam F, Venepally NR et al. Comparison of echocardiographic parameters with cardiac magnetic resonance imaging in the assessment of right ventricular function. Echocardiography. 2020;37(11):1792–802. DOI: 10.1111/echo.14877Jurcut R, Giusca S, La Gerche A, Vasile S, Ginghina C, Voigt J-U. The echocardiographic assessment of the right ventricle: what to do in 2010? European Journal of Echocardiography. 2010;11(2):81–96. DOI: 10.1093/ejechocard/jep234Simsek E, Nalbantgil S, Ceylan N, Zoghi M, Kemal HS, Engin C et al. Assessment of right ventricular systolic function in heart transplant patients: Correlation between echocardiography and cardiac magnetic resonance imaging. Investigation of the accuracy and reliability of echocardiography. Echocardiography. 2017;34(10):1432–8. DOI: 10.1111/echo.13650Agasthi P, Chao C, Siegel RJ, Pujari SH, Mookadam F, Venepally NR et al. Comparison of echocardiographic parameters with cardiac magnetic resonance imaging in the assessment of right ventricular function. Echocardiography. 2020;37(11):1792–802. DOI: 10.1111/echo.14877Barman HA, Atici A, Tekin EA, Baycan OF, Alici G, Meric BK et al. Echocardiographic features of patients with COVID-19 infection: a cross-sectional study. The International Journal of Cardiovascular Imaging. 2021;37(3):825–34. DOI: 10.1007/s10554-020-02051-9Simsek E, Nalbantgil S, Ceylan N, Zoghi M, Kemal HS, Engin C et al. Assessment of right ventricular systolic function in heart transplant patients: Correlation between echocardiography and cardiac magnetic resonance imaging. Investigation of the accuracy and reliability of echocardiography. Echocardiography. 2017;34(10):1432–8. DOI: 10.1111/echo.13650Bleakley C, Singh S, Garfield B, Morosin M, Surkova E, Mandalia MS et al. Right ventricular dysfunction in critically ill COVID-19 ARDS. International Journal of Cardiology. 2021;327:251–8. DOI: 10.1016/j.ijcard.2020.11.043Barman HA, Atici A, Tekin EA, Baycan OF, Alici G, Meric BK et al. Echocardiographic features of patients with COVID-19 infection: a cross-sectional study. The International Journal of Cardiovascular Imaging. 2021;37(3):825–34. DOI: 10.1007/s10554-020-02051-9Yoshifuku S, Otsuji Y, Takasaki K, Yuge K, Kisanuki A, Toyonaga K et al. Pseudonormalized doppler totalejection isovolume (Tei) index in patients with right ventricularacute myocardial infarction. The American Journal of Cardiology. 2003;91(5):527–31. DOI: 10.1016/S0002-9149(02)03299-XBleakley C, Singh S, Garfield B, Morosin M, Surkova E, Mandalia MS et al. Right ventricular dysfunction in critically ill COVID-19 ARDS. International Journal of Cardiology. 2021;327:251–8. DOI: 10.1016/j.ijcard.2020.11.043Valsangiacomo Buechel ER, Mertens LL. Imaging the right heart: the use of integrated multimodality imaging. European Heart Journal. 2012;33(8):949–60. DOI: 10.1093/eurheartj/ehr490Yoshifuku S, Otsuji Y, Takasaki K, Yuge K, Kisanuki A, Toyonaga K et al. Pseudonormalized doppler totalejection isovolume (Tei) index in patients with right ventricularacute myocardial infarction. The American Journal of Cardiology. 2003;91(5):527–31. DOI: 10.1016/S0002-9149(02)03299-XWright L, Dwyer N, Power J, Kritharides L, Celermajer D, Marwick TH. Right Ventricular Systolic Function Responses to Acute and Chronic Pulmonary Hypertension: Assessment with Myocardial Deformation. Journal of the American Society of Echocardiography. 2016;29(3):259–66. DOI: 10.1016/j.echo.2015.11.010Valsangiacomo Buechel ER, Mertens LL. Imaging the right heart: the use of integrated multimodality imaging. European Heart Journal. 2012;33(8):949–60. DOI: 10.1093/eurheartj/ehr490Karagodin I, Carvalho Singulane C, Woodward GM, Xie M, Tucay ES, Tude Rodrigues AC et al. Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study. Journal of the American Society of Echocardiography. 2021;34(8):819–30. DOI: 10.1016/j.echo.2021.05.010Wright L, Dwyer N, Power J, Kritharides L, Celermajer D, Marwick TH. Right Ventricular Systolic Function Responses to Acute and Chronic Pulmonary Hypertension: Assessment with Myocardial Deformation. Journal of the American Society of Echocardiography. 2016;29(3):259–66. DOI: 10.1016/j.echo.2015.11.010Teske AJ, De Boeck BWL, Olimulder M, Prakken NH, Doevendans PAF, Cramer MJ. Echocardiographic Assessment of Regional Right Ventricular Function: A Head-to-head Comparison Between 2-Dimensional and Tissue Doppler–derived StrainAnalysis. Journal of the American Society of Echocardiography. 2008;21(3):275–83. DOI: 10.1016/j.echo.2007.08.027Karagodin I, Carvalho Singulane C, Woodward GM, Xie M, Tucay ES, Tude Rodrigues AC et al. Echocardiographic Correlates of In-Hospital Death in Patients with Acute COVID-19 Infection: The World Alliance Societies of Echocardiography (WASE-COVID) Study. Journal of the American Society of Echocardiography. 2021;34(8):819–30. DOI: 10.1016/j.echo.2021.05.010D’Alto M, Marra AM, Severino S, Salzano A, Romeo E, De Rosa R et al. Right ventricular-arterial uncoupling independently predicts survival in COVID-19 ARDS. Critical Care. 2020;24(1):670. DOI: 10.1186/s13054-020-03385-5Teske AJ, De Boeck BWL, Olimulder M, Prakken NH, Doevendans PAF, Cramer MJ. Echocardiographic Assessment of Regional Right Ventricular Function: A Head-to-head Comparison Between 2-Dimensional and Tissue Doppler–derived StrainAnalysis. Journal of the American Society of Echocardiography. 2008;21(3):275–83. DOI: 10.1016/j.echo.2007.08.027Wibowo A, Pranata R, Astuti A, Tiksnadi BB, Martanto E, Martha JW et al. Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis. Journal of Intensive Care. 2021;9(1):9. DOI: 10.1186/s40560-020-00519-3D’Alto M, Marra AM, Severino S, Salzano A, Romeo E, De Rosa R et al. Right ventricular-arterial uncoupling independently predicts survival in COVID-19 ARDS. Critical Care. 2020;24(1):670. DOI: 10.1186/s13054-020-03385-5Baycan OF, Barman HA, Atici A, Tatlisu A, Bolen F, Ergen P et al. Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography. The International Journal of Cardiovascular Imaging. 2021;37(1):135–44. DOI: 10.1007/s10554-020-01968-5Wibowo A, Pranata R, Astuti A, Tiksnadi BB, Martanto E, Martha JW et al. Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis. Journal of Intensive Care. 2021;9(1):9. DOI: 10.1186/s40560-020-00519-3Alpert JS. The effect of Right Ventricular Dysfunction on Left Ventricular Form and Function. Chest. 2001;119(6):1632–3. DOI: 10.1378/chest.119.6.1632Baycan OF, Barman HA, Atici A, Tatlisu A, Bolen F, Ergen P et al. Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography. The International Journal of Cardiovascular Imaging. 2021;37(1):135–44. DOI: 10.1007/s10554-020-01968-5Krishnamoorthy P, Croft LB, Ro R, Anastasius M, Zhao W, Giustino G et al. Biventricular strain by speckle tracking echocardiography in COVID-19: findings and possible prognostic implications. Future Cardiology. 2021;17(4):663–7. DOI: 10.2217/fca-2020-0100Alpert JS. The effect of Right Ventricular Dysfunction on Left Ventricular Form and Function. Chest. 2001;119(6):1632–3. DOI: 10.1378/chest.119.6.1632Lassen MCH, Skaarup KG, Lind JN, Alhakak AS, Sengeløv M, Nielsen AB et al. Echocardiographic abnormalities and predictors of mortality in hospitalized COVID‐19 patients: the ECHOVID‐19 study. ESC Heart Failure. 2020;7(6):4189–97. DOI: 10.1002/ehf2.13044Krishnamoorthy P, Croft LB, Ro R, Anastasius M, Zhao W, Giustino G et al. Biventricular strain by speckle tracking echocardiography in COVID-19: findings and possible prognostic implications. Future Cardiology. 2021;17(4):663–7. DOI: 10.2217/fca-2020-0100Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648–55. DOI: 10.1161/CIRCULATIONAHA.120.046941Lassen MCH, Skaarup KG, Lind JN, Alhakak AS, Sengeløv M, Nielsen AB et al. Echocardiographic abnormalities and predictors of mortality in hospitalized COVID‐19 patients: the ECHOVID‐19 study. ESC Heart Failure. 2020;7(6):4189–97. DOI: 10.1002/ehf2.13044Голухова Е.З., Сливнева И.В., Рыбка М.М., Мамалыга М.Л., Алехин М.Н., Ключников И.В. и др. Легочная гипертензия как фактор оценки риска неблагоприятного исходау пациентов с COVID-19. Российский кардиологический журнал. 2020;25(12):121-33. DOI: 10.15829/1560-4071-2020-4136Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648–55. DOI: 10.1161/CIRCULATIONAHA.120.046941Hatle L, Angelsen BA, Tromsdal A. Non-invasive estimation of pulmonary artery systolic pressure with Doppler ultrasound. Heart. 1981;45(2):157–65. DOI: 10.1136/hrt.45.2.157Golukhova E.Z., Slivneva I.V., Rybka M.M., Mamalyga M.L., Alekhin M.N., Klyuchnikov I.V. et al. Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19. Russian Journal of Cardiology. 2020;25(12):121–33. DOI: 10.15829/1560-4071-2020-4136Masuyama T, Kodama K, Kitabatake A, Sato H, Nanto S, Inoue M. Continuous-wave Doppler echocardiographic detection of pulmonary regurgitation and its application to noninvasive estimation of pulmonary artery pressure. Circulation. 1986;74(3):484–92. DOI: 10.1161/01.CIR.74.3.484Hatle L, Angelsen BA, Tromsdal A. Non-invasive estimation of pulmonary artery systolic pressure with Doppler ultrasound. Heart. 1981;45(2):157–65. DOI: 10.1136/hrt.45.2.157Magnino C, Omedè P, Avenatti E, Presutti D, Iannaccone A, Chiarlo M et al. Inaccuracy of Right Atrial Pressure Estimates Through Inferior Vena Cava Indices. The American Journal of Cardiology. 2017;120(9):1667–73. DOI: 10.1016/j.amjcard.2017.07.069Masuyama T, Kodama K, Kitabatake A, Sato H, Nanto S, Inoue M. Continuous-wave Doppler echocardiographic detection of pulmonary regurgitation and its application to noninvasive estimation of pulmonary artery pressure. Circulation. 1986;74(3):484–92. DOI: 10.1161/01.CIR.74.3.484Lanzarini L, Fontana A, Lucca E, Campana C, Klersy C. Noninvasive estimation of both systolic and diastolic pulmonary artery pressure from Doppler analysis of tricuspid regurgitant velocity spectrum in patients with chronic heart failure. American Heart Journal. 2002;144(6):1087–94. DOI: 10.1067/mhj.2002.126350Magnino C, Omedè P, Avenatti E, Presutti D, Iannaccone A, Chiarlo M et al. Inaccuracy of Right Atrial Pressure Estimates Through Inferior Vena Cava Indices. The American Journal of Cardiology. 2017;120(9):1667–73. DOI: 10.1016/j.amjcard.2017.07.069Lindqvist P, Soderberg S, Gonzalez MC, Tossavainen E, Henein MY. Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study. European Journal of Echocardiography. 2011;12(12):961–6. DOI: 10.1093/ejechocard/jer222Lanzarini L, Fontana A, Lucca E, Campana C, Klersy C. Noninvasive estimation of both systolic and diastolic pulmonary artery pressure from Doppler analysis of tricuspid regurgitant velocity spectrum in patients with chronic heart failure. American Heart Journal. 2002;144(6):1087–94. DOI: 10.1067/mhj.2002.126350Opotowsky AR, Clair M, Afilalo J, Landzberg MJ, Waxman AB, Moko L et al. A Simple Echocardiographic Method to Estimate Pulmonary Vascular Resistance. The American Journal of Cardiology. 2013;112(6):873–82. DOI: 10.1016/j.amjcard.2013.05.016Lindqvist P, Soderberg S, Gonzalez MC, Tossavainen E, Henein MY. Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study. European Journal of Echocardiography. 2011;12(12):961–6. DOI: 10.1093/ejechocard/jer222Guazzi M, Dixon D, Labate V, Beussink-Nelson L, Bandera F, Cuttica MJ et al. RV Contractile Function and its Coupling to Pulmonary Circulation in Heart Failure With Preserved Ejection Fraction. JACC: Cardiovascular Imaging. 2017;10(10 Pt B):1211–21. DOI: 10.1016/j.jcmg.2016.12.024Opotowsky AR, Clair M, Afilalo J, Landzberg MJ, Waxman AB, Moko L et al. A Simple Echocardiographic Method to Estimate Pulmonary Vascular Resistance. The American Journal of Cardiology. 2013;112(6):873–82. DOI: 10.1016/j.amjcard.2013.05.016Tello K, Wan J, Dalmer A, Vanderpool R, Ghofrani HA, Naeije R et al. Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension. Circulation: Cardiovascular Imaging. 2019;12(9):e009047. DOI: 10.1161/CIRCIMAGING.119.009047Guazzi M, Dixon D, Labate V, Beussink-Nelson L, Bandera F, Cuttica MJ et al. RV Contractile Function and its Coupling to Pulmonary Circulation in Heart Failure With Preserved Ejection Fraction. JACC: Cardiovascular Imaging. 2017;10(10 Pt B):1211–21. DOI: 10.1016/j.jcmg.2016.12.024Bashline MJ, Simon MA. Use of Tricuspid Annular Plane Systolic Excursion/Pulmonary Artery Systolic Pressure As a Non-Invasive Method to Assess Right Ventricular-PA Coupling in Patients With Pulmonary Hypertension. Circulation: Cardiovascular Imaging. 2019;12(9): e009648. DOI: 10.1161/CIRCIMAGING.119.009648Tello K, Wan J, Dalmer A, Vanderpool R, Ghofrani HA, Naeije R et al. Validation of the Tricuspid Annular Plane Systolic Excursion/Systolic Pulmonary Artery Pressure Ratio for the Assessment of Right Ventricular-Arterial Coupling in Severe Pulmonary Hypertension. Circulation: Cardiovascular Imaging. 2019;12(9):e009047. DOI: 10.1161/CIRCIMAGING.119.009047Kelly RP, Ting CT, Yang TM, Liu CP, Maughan WL, Chang MS et al. Effective arterial elastance as index of arterial vascular load in humans. Circulation. 1992;86(2):513–21. PMID: 1638719Bashline MJ, Simon MA. Use of Tricuspid Annular Plane Systolic Excursion/Pulmonary Artery Systolic Pressure As a Non-Invasive Method to Assess Right Ventricular-PA Coupling in Patients With Pulmonary Hypertension. Circulation: Cardiovascular Imaging. 2019;12(9): e009648. DOI: 10.1161/CIRCIMAGING.119.009648Knai K, Skjaervold NK. A pig model of acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction. BMC Research Notes. 2017;10(1):2. DOI: 10.1186/s13104-016-2333-7Kelly RP, Ting CT, Yang TM, Liu CP, Maughan WL, Chang MS et al. Effective arterial elastance as index of arterial vascular load in humans. Circulation. 1992;86(2):513–21. PMID: 1638719Topilsky Y, Oh JK, Shah DK, Boilson BA, Schirger JA, Kushwaha SS et al. Echocardiographic Predictors of Adverse Outcomes After Continuous Left Ventricular Assist Device Implantation. JACC: Cardiovascular Imaging. 2011;4(3):211–22. DOI: 10.1016/j.jcmg.2010.10.012Knai K, Skjaervold NK. A pig model of acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction. BMC Research Notes. 2017;10(1):2. DOI: 10.1186/s13104-016-2333-7Vieillard-Baron A, Price LC, Matthay MA. Acute cor pulmonale in ARDS. Intensive Care Medicine. 2013;39(10):1836–8. DOI: 10.1007/s00134-013-3045-2Topilsky Y, Oh JK, Shah DK, Boilson BA, Schirger JA, Kushwaha SS et al. Echocardiographic Predictors of Adverse Outcomes After Continuous Left Ventricular Assist Device Implantation. JACC: Cardiovascular Imaging. 2011;4(3):211–22. DOI: 10.1016/j.jcmg.2010.10.012Vieillard-Baron A, Price LC, Matthay MA. Acute cor pulmonale in ARDS. Intensive Care Medicine. 2013;39(10):1836–8. DOI: 10.1007/s00134-013-3045-2Vieillard-Baron A, Price LC, Matthay MA. Acute cor pulmonale in ARDS. Intensive Care Medicine. 2013;39(10):1836–8. DOI: 10.1007/s00134-013-3045-2

The authors declare that there are no conflicts of interest present.