CONCLUSION
This study demonstrated that positive T aVR wave in the lead aVR was a
significant and independent risk factor for mortality from COVID-19
infection. This unique ECG parameter, which is often overlooked,
provides information on the mortality of patients even when other ECG
parameters are normal. We recommend that a positive TAVR wave not be
neglected when evaluating high-risk patients.
FIGURE LEGEND
Table 1 Baseline Characteristics, Electrocardiographic Findings
Table 2 Basıc Laboratory Parameters Of Patients
Table 3 Comparison of The Electrocardiographic Findings To deceased and
living group
Table 4 Effects Of Various Variables On COVID-19 Mortality İn Univariate
And Multivariate Logistic Regression Analyses
REFERENCES
1)Francesca Mai (MD) COVID-19 and cardiovascular diseases Journal of
Cardiology 76 (2020) 453–458
2) Doyen D, Moceri P, Ducreux D, Dellamonica J. Myocarditis in a patient
with COVID-19: a cause of raised troponin and ECG changes. Lancet.
2020;395(10235):1516.
3) Kim IC, Kim JY, Kim HA, Han S. COVID-19-related myocarditis in a
21-year-old femalepatient. Eur Heart J. 2020;41:1859.
4) Cizgici AY, Zencirkiran Agus H, YildizM. COVID-19myopericarditis: it
should be kept in mind in today’s conditions. Am J Emerg Med. 2020.
https://doi.org/10.1016/j.
ajem.2020.04.080 Epub 2020 Apr 28.
5) Dabbagh MF, Aurora L, D’Souza P, et al. Cardiac tamponade secondary
to COVID-19.
JACC Case Rep. 2020. https://doi.org/10.1016/j.jaccas.2020.04.009 Epub
2020 Apr 23.
6) Inciardi RM, Lupi L, Zaccone G, et al. Cardiac involvement in a
patient with coronavirusdisease 2019 (COVID-19). JAMA Cardiol. 2020.
https://doi.org/10.1001/
jamacardio.2020.1096 Epub 2020 Mar 27.
7) Wang MS1 Cardiac arrhythmias in patients with COVID-19Journal
of Arrhythmia. 2020;36:827–836.
8) Vidovich MI. Transient Brugada-like ECG pattern in a patient with
coronavirus disease2019 (COVID-19). JACC Case Rep. 2020.
https://doi.org/10.1016/j.jaccas.2020.04.007 Epub 2020 Apr 16.
9) Yenerçağ M. Evaluation of electrocardiographic ventricular
repolarization variables in patients with newly diagnosed COVID-19 /
Journal of Electrocardiology 62 (2020) 5–9
10) Adriano Nunes KochiCardiac and arrhythmic complications in patients
with COVID‐19 J Cardiovasc Electrophysiol. 2020;31:1003–1008
11)Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications
in COVID-19. Am J Emerg Med. 2020.https://doi.org/10.1016/j.ajem.2020.04.048
Epub 2020Apr 18.
12) Shi S, QinM, Shen B, Cai Y, Liu T, Yang F, et al. Association of
cardiac injury withmortalityin hospitalized patients with COVID-19
inWuhan, China. JAMA Cardiol. 2020:e200950.https://doi.org/10.1001/jamacardio.2020.0950
13)Oudit GY, Kassiri Z, Jiang C, Liu PP, Poutanen SM, Penninger JM, et
al.
SARScoronavirus modulation of myocardial ACE2 expression and
inflammation in
patients with SARS. Eur J Clin Invest. 2009;39:618–25.
14)Pan SF, Zhang HY, Li CS, Wang C. Cardiac arrest in severe acute
respiratory syndrome: analysis of 15 cases. Zhonghua Jie He He Hu Xi Za
Zhi. 2003;26:602–5
15) Erkan Ayhan,Prognostic Significance of T-Wave Amplitude in Lead
aVR on the Admission Electrocardiography in Patients with Anterior Wall
ST-Elevation Myocardial Infarction Treated by Primary Percutaneous
Intervention Ann Noninvasive Electrocardiol 2013;18(1):51–57
16) İçenYK. ST segment change and T wave amplitude ratio inlead aVR
associated with coronary artery diseaseseverity in patients with non-ST
elevation myocardial infarction Medicine (2017) 96:49
17) Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu
X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y,
Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao
B.. Clinical features of patients infected with 2019 novel coronavirus
in Wuhan, China. Lancet 2020;395:497–506.
18) Oudit GY, Kassiri Z, Jiang C, et al. SARS‐coronavirus modulation of
myocardial ACE2 expression and inflammation in patients with SAR.
Eur J Clin Invest. 2009;39:618‐625.
19) Wong CK, Lam CW, Wu AK, et al. Plasma inflammatory cytokines and
chemokines in severe acute respiratory syndrome. Clin Exp Immunol.
2004;136:95‐103
20) Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal
outcomes of patients with coronavirus disease 2019 (COVID‐19).
JAMA Cardiol. 2020.https://doi.org/10.1001/jamacardio.2020.1017
21) Zhao B, Ni C, Gao R, Wang Y, Yang L, Wei J, et al. Recapitulation of
SARS-CoV-2 infection and cholangiocyte damage with human liver ductal
organoids. Protein Cell. 2020;https://doi.org/10.1007/s13238-020-00718
-6. [Epub ahead of print].
22)Wang D, Hu B, Hu C, et al. Clinical characteristics of 138
hospitalized
patients with 2019 novel coronavirus‐infected pneumonia in wuhan,
China. JAMA. 2020. https://doi.org/10.1001/jama.2020.1585FF
23) Kireyev D, Arkhipov MV, Zador ST, et al. Clinical utility of
aVR-the neglected electrocardiographic lead. Ann Noninvasive
Electrocardiol 2010; 15: 175-80.
24 Shinozaki K, Tamura A, Kadota J. Associations of positive
T wave in lead aVR with hemodynamic, coronary, and left
ventricular angiographic findings in anterior wall old myocardial
infarction. J Cardiol 2011;57:160–164
25 George, A., Arumugham, P. S., & Figueredo, V. M. (2010). aVR ‐ The
forgotten
lead. Experimental and Clinical Cardiology , 15 (2),
e36–e44.
26Tan,The Prognostic Value of T Wave Amplitude in Lead aVR in Males Ann
Noninvasive Electrocardiol 2008;13(2):113–119
27) Okuda K, M.D Prognostic Significance of T-Wave Amplitude in Lead aVR
in Heart Failure Patients with Narrow QRS Complexes Ann Noninvasive
Electrocardiol 2011;16(3):250–257
28) Y. Tanaka Impact of T wave amplitude in lead aVR on predicting
cardiac
events in ischemic and nonischemic cardiomyopathy patients
with an implantable cardioverter defibrillator Ann Noninvasive
Electrocardiol. 2017;22:e12452. ttps://doi.org/10.1111/anec.12452
29) Dönmez Y,T wave positivity in lead aVR is associated with
mortality after transcatheter aortic valve implantation Arch Med Sci
Atheroscler Dis 2019; 4: e55–e62
30) Badheka, A. O., Patel, N. J., Grover, P. M., Shah, N., Singh, V.,
Deshmukh,
A., … Cohen, M. G. (2013). ST‐T wave abnormality in lead aVR
andreclassification of cardiovascular risk (from the National Health
andNutrition Examination Survey‐III). American Journal of
Cardiology ,112 (6), 805
810.https://doi.org/10.1016/j.amjcard.2013.04.058
31) Ekizler The prognostic value of positive T wave in lead aVR: A novel
marker of adverse cardiac outcomes in peripartum
Cardiomyopathy Ann Noninvasive Electrocardiol. 2019;24:e12631.