Hyperdynamic left ventricular ejection fraction is associated with higher mortality in COVID-19 patients

Am Heart J Plus. 2022 Feb;14:100134. doi: 10.1016/j.ahjo.2022.100134. Epub 2022 Apr 18.


Study objective: To compare the characteristics and outcomes of COVID-19 patients with a hyperdynamic LVEF (HDLVEF) to those with a normal or reduced LVEF.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: Of the 1682 adult patients hospitalized with COVID-19, 419 had a transthoracic echocardiogram (TTE) during admission and met study inclusion criteria.

Interventions: Participants were divided into reduced (LVEF < 50%), normal (≥50% and <70%), and hyperdynamic (≥70%) LVEF groups.

Main outcome measures: LVEF was assessed as a predictor of 60-day mortality. Logistic regression was used to adjust for age and BMI.

Results: There was no difference in 60-day mortality between patients in the reduced LVEF and normal LVEF groups (adjusted odds ratio [aOR] 0.87, p = 0.68). However, patients with an HDLVEF were more likely to die by 60 days compared to patients in the normal LVEF group (aOR 2.63 [CI: 1.36-5.05]; p < 0.01). The HDLVEF group was also at higher risk for 60-day mortality than the reduced LVEF group (aOR 3.34 [CI: 1.39-8.42]; p < 0.01).

Conclusion: The presence of hyperdynamic LVEF during a COVID-19 hospitalization was associated with an increased risk of 60-day mortality, the requirement for mechanical ventilation, vasopressors, and intensive care unit.

Keywords: COVID-19; COVID-19, coronavirus disease 2019; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; Heart failure; Hyperdynamic; ICU, intensive care unit; LVEF, left ventricular ejection fraction; Left ventricular ejection fraction; MACE, major adverse cardiovascular events; NLVEF, normal left ventricular ejection fraction; RLVEF, reduced left ventricular ejection fraction; SARS-CoV-2; TTE, transthoracic echocardiogram.