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Background Coronavirus disease 2019 (COVID-19) is a growing pandemic that confers augmented risk for right ventricular (RV) dysfunction and dilation; the prognostic utility of adverse RV remodeling in COVID-19 patients is uncertain. Objectives The purpose of this study was to test whether adverse RV remodeling (dysfunction/dilation) predicts COVID-19 prognosis independent of clinical and biomarker risk stratification. Methods Consecutive COVID-19 inpatients undergoing clinical transthoracic echocardiography at 3 New York City hospitals were studied; images were analyzed by a central core laboratory blinded to clinical and biomarker data. Results In total, 510 patients (age 64 ± 14 years, 66% men) were studied; RV dilation and dysfunction were present in 35% and 15%, respectively. RV dysfunction increased stepwise in relation to RV chamber size (p = 0.007). During inpatient follow-up (median 20 days), 77% of patients had a study-related endpoint (death 32%, discharge 45%). RV dysfunction (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.49 to 4.43; p = 0.001) and dilation (HR: 1.43; 95% CI: 1.05 to 1.96; p = 0.02) each independently conferred mortality risk. Patients without adverse RV remodeling were more likely to survive to hospital discharge (HR: 1.39; 95% CI: 1.01 to 1.90; p = 0.041). RV indices provided additional risk stratification beyond biomarker strata; risk for death was greatest among patients with adverse RV remodeling and positive biomarkers and was lesser among patients with isolated biomarker elevations (p ≤ 0.001). In multivariate analysis, adverse RV remodeling conferred a >2-fold increase in mortality risk, which remained significant (p, Central Illustration

Background Biomarker-evidenced myocardial injury is common among patients with COVID-19 infection and confers an increased risk of mortality Prevalence and incremental prognostic impact of myocardial dysfunction is unknown Methods Consecutive COVID-19 patients undergoing clinical echocardiography during their index hospitalization at three New York City hospitals were studied Images were analyzed by a central core lab blinded to all clinical data LV dysfunction was defined as LVEF < 55% and RV dysfunction as TAPSE

Echocardiography is widely used to assess right ventricular (RV) function; current techniques are limited by need for dedicated imaging and manual analysis. Deep learning holds potential to improve RV assessment but has yet to be well validated. A deep learning model was developed to track

Clinically apparent myocardial infarction (MI) is a well-known risk factor for ischemic stroke, but the role of unrecognized MI as a risk factor for stroke is not yet established. We aimed to evaluate the association between unrecognized MI and cerebral infarction. We performed a retrospective

MitraClip (MClp) is a novel percutaneous approach to treat mitral regurgitation (MR) but response is variable. Cardiac chamber geometry impacts MR; effect on MClp response is unknown. The population comprised advanced (>moderate) MR pts undergoing MClp who had clinical transthoracic echo done pre

Surgical bioprosthetic valves on average begin to fail at about 9 years. Elderly patients with failing heart valves are often at high risk for re-operation which can preclude them from open heart surgery. Registries of valve-in-valve (ViV) transcatheter heart valve (THV) replacement for either

Mitral regurgitation (MR) is a nidus for RV dysfunction (RVdys) - a known poor prognostic marker. Echocardiography (echo) is widely used to screen for RVdys but relative utility of established and emerging echo approaches is unknown. Population comprised ischemic MR (iMR) pts undergoing a

High-sensitivity troponin (hsTrop) assays can detect smaller myocardial infarctions (MI) undetectable with contemporary troponin assays (cTrop), it is unclear whether patients with hsTrop elevations in setting of normal cTrop have higher mortality. A search was made of PubMed, CENTRAL, EMBASE

RV chamber remodeling impacts prognosis. Echo linear dimensions are widely used for LV assessment, but are not well validated as quantitative indices of RV size. The population comprised post MI pts undergoing transthoracic echo and CMR within 1 day. On echo, RV end diastolic (ED) and end systolic