Although severe acute respiratory syndrome coronavirus 2 causes respiratory disease, it may also lead to cardiovascular involvement with unknown long-term consequences. The aim of our study was to evaluate prospectively cardiac involvement in patients after the recovery from Covid-19, using two-dimensional speckle tracking echocardiography. 100 Covid-19 recovered patients with preserved left ventricular ejection fraction, were included, divided based upon clinical manifestation into two groups, those who were treated ambulant and those who were hospitalized. All patients underwent echocardiographic evaluation after their recovery. Although overall LV systolic function expressed by EF was normal, left ventricular global longitudinal strain (LVGLS) was significantly lower in Covid-19 recovered patients (33.28 ± 9.4 days after diagnosis) compared to controls (− 18.47 ± − 2.4 vs. − 21.07 ± − 1.76% respectively, p < 0.0001). Εspecially the lateral wall longitudinal strain (LATLS) and posterior wall longitudinal strain (POSTLS) were significantly reduced in all patients compared to controls (− 17.77 ± − 3.48 vs. − 20.97 ± − 2.86%, p < 0.0001 and − 19.52 ± − 5.3 vs. − 22.23 ± − 2.65%, p = 0.01). right ventricular global longitudinal strain (RVGLS) was significantly diminished only in the hospitalized group of Covid-19 recovered patients, compared to controls (− 18.17 ± − 3.32 vs. − 26.03 ± − 4.55% respectively, p < 0.0001). LVGLS is affected in almost all individuals after Covid-19 infection independently of the infection severity, with LATLS being the most sensitive marker of LV impairment and with POSTLS to follow. RV shows impaired GLS in severely ill patients highlighting RVGLS as a helpful tool of prognosis. Recovered patients from Covid-19 infection have to be monitored for a long time, since the term “long Covid disease” might also include the cardiac function.
Introduction
Profound changes occur in the cardiovascular system during pregnancy, regarding to induce cardiac pumping function. Although LV systolic and diastolic function have been thoroughly studied using conventional indices, speckle tracking parameters of cardiac function are not well described.
Purpose
The aim of our study was to evaluate the LV diastolic function during an uncomplicated pregnancy using both traditional and newer speckle tracking parameters.
Methods
We prospectively enrolled 40 consecutive pregnant women in whom serial echocardiographic evaluation was performed in each pregnancy trimester (1st: 8th–12th week, 2nd: 22th–26th week, 3rd: 32–36th week) and 6 months after delivery. Mitral inflow velocities (E, A), mitral annulus TDI velocities (E', A'), ratio E/A and E/E' and untwisting velocity rate were measured after cautious selection of studies with legible images in.
Results
The peak E transmitral inflow velocity during early diastole decreased significantly during pregnancy especially between 2nd and 3rd trimester and increased again postpartum (p1-2=0.475, p2-3<0.05 p3-4<0.05). The peak A flow velocity during atrial contraction did not change significantly during pregnancy (p1-2=0.333, p2-3=0.952, p3-4=0.989). As a result, E/A ratio was decreasing as pregnancy was advancing (p1-2=0.964, p2-3<0.05, p3-4=0.240). TDI E' early diastolic velocity was decreased especially in the 3rd trimester and recovered postpartum (p1-2=0.138, p2-3<0.01, p3-4<0.01) while E/E' ratio was increased especially in the 2nd trimester (p1-2<0.05, p2-3=0.572, p3-4=0.021, p1-4=0.383) and also recovered postpartum. Peak untwisting velocity rate demontrated a progressive decrease during pregnancy, although not statistically significant. There was a trend towards recovery in the puerperium (p1-2=0.072, p2-3=0.679, p3-4=0.052, p1-4=0.929) (Table 1).
Conclusion
Our study demonstrated that diastolic function seems to be impaired during an uncomplicated pregnancy. However all the conventional and newer speckle tracking indices of diastolic function remain in normal range. Postpartum appears to be a recovery process in all parameters.
FUNDunding Acknowledgement
Type of funding sources: None.
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