The association between coronary artery calcification and vectorcardiography in mechanically ventilated COVID-19 patients: the Maastricht Intensive Care COVID cohort.

Publication date: Mar 07, 2024

Coronary artery calcification (CAC) is associated with poor outcome in critically ill patients. A deterioration in cardiac conduction and loss of myocardial tissue could be an underlying cause. Vectorcardiography (VCG) and cardiac biomarkers provide insight into these underlying causes. The aim of this study was to investigate whether a high degree of CAC is associated with VCG-derived variables and biomarkers, including high-sensitivity troponin-T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Mechanically ventilated coronavirus-19 (COVID-19) patients with an available chest computed tomography (CT) and 12-lead electrocardiogram (ECG) were studied. CAC scores were determined using chest CT scans. Patients were categorized into 3 sex-specific tertiles: low, intermediate, and high CAC. Daily 12 leads-ECGs were converted to VCGs. Daily hs-cTnT and NT-proBNP levels were determined. Linear mixed-effects regression models examined the associations between CAC tertiles and VCG variables, and between CAC tertiles and hs-cTnT or NT-proBNP levels. In this study, 205 patients (73. 2% men, median age 65 years [IQR 57. 0; 71. 0]) were included. Compared to the lowest CAC tertile, the highest CAC tertile had a larger QRS area at baseline (6. 65 uVs larger [1. 50; 11. 81], p = 0. 012), which decreased during admission (- 0. 27 uVs per day [- 0. 43; – 0. 11], p = 0. 001). Patients with the highest CAC tertile also had a longer QRS duration (12. 02 ms longer [4. 74; 19. 30], p = 0. 001), higher levels of log hs-cTnT (0. 79 ng/L higher [0. 40; 1. 19], p 

Concepts Keywords
Covid COVID-19
Daily Intensive care unit
Myocardial Vascular calcification
Poor Vectorcardiography


Type Source Name
disease MESH COVID-19
disease MESH critically ill
pathway REACTOME Cardiac conduction
disease MESH causes
disease MESH Vascular calcification

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