First-phase ejection fraction is a strong predictor of survival in hospitalized COVID-19 patients. New research published in the journal Hypertension says that hospitalized COVID-19 patients with impaired first-phase ejection fraction were nearly 5 times more likely to die compared to patients with normal first-phase ejection fraction.

Heart function is traditionally measured by the ejection fraction.  First-phase ejection fraction has been proposed as a new measure of heart function. It is a measure of the left ventricular ejection fraction (LVEF) until the time of maximal ventricular contraction. It can identify early, undetected or subtle damage to the heart (sign of heart failure) compared to the conventionally used ejection fraction.

The study examined mortality rates of hospitalized COVID-19 patients in Wuhan, China (n=129) and in South London (n=251). The echocardiography results of COVID-19 patients were compared to adult patients who had an echocardiography done pre-COVID and had otherwise similar health profiles.

• COVID-19 patients with a first-phase ejection fraction < 25% had a nearly 5-fold higher risk of death vs. patients in whom the ejection fraction was ≥ 25%.
• Patients who did not have COVID-19, but had similar risk factors, also had low first-phase ejection fraction, suggesting that the damage to the heart may be due to chronic pre-existing conditions and not COVID-19 infection.

These findings suggest first-phase ejection fraction can be used as a novel marker to identify high-risk COVID-19 patients. They can be closely monitored and death can be possibly prevented by preventing very early chronic damage to the heart. However, the researchers caution that more studies are needed to verify this.

(Source: AHA News Release, Published: May 10, 2021)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA