Cardiac Involvement in Patients Recovered From COVID-19 Identified Using Left Ventricular Longitudinal Strain

Caiado, Luiz Darcy Cortez; Azevedo, Nathalia Caiado de; Azevedo, Rafael R. C.; Caiado, Brasil

doi:10.21203/rs.3.rs-470171/v1

Cited by 4 publications

(9 citation statements)

References 25 publications

(36 reference statements)

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“…Another study included 100 patients recovered from COVID-19 at a median delay of 130 days. Overall GLS was not reduced in post-COVID patients, but the basal segmental longitudinal strain was found to be lower [13]. Yet another study included 86 COVID-19 survivors late (median time interval 327 days) after recovery.…”

Section: Limitationsmentioning

confidence: 92%

“…Only a few studies have reported GLS in patients recently recovered from COVID-19 [12][13][14]. A study from North India included 134 subjects within 30-45 days after recovery from COVID-19 [12].…”

Section: Limitationsmentioning

confidence: 99%

“…These findings show the utility of GLS in the evaluation of the post-COVID population and suggest that GLS should be measured in every symptomatic post-COVID patient to detect underlying myocardial dysfunction. inclusion of such subjects as controls allowed us to better assess the true prevalence of LV myocardial dysfunction in post-COVID patients than in the previous studies [12,13]. Lastly, our study was initiated at a time when COVID vaccination had not become available in India.…”

Section: Limitationsmentioning

confidence: 99%

“…Hence, timely recognition and management of any residual myocardial damage in COVID-19 may be clinically important. Unfortunately, only limited longterm data is available regarding cardiovascular involvement in the convalescent phase of COVID-19 [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…However, the wider use of CMR is not practical due to its cost and other logistic challenges. In this context, strain imaging could be a useful tool for diagnosing subclinical myocardial dysfunction [12][13][14]. The present study was therefore sought to characterize the extent of residual myocardial dysfunction using strain imaging in patients who had recently recovered from COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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Clinical profile and the extent of residual myocardial dysfunction among patients with previous coronavirus disease 2019

Bansal

2023

Int J Cardiovasc Imaging

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SARS-CoV-2), has exhibited a wide spectrum of acute presentations ranging from asymptomatic form to severe respiratory distress, myocardial injury, and even death. Approximately 20-30% of the patients developing COVID-19 have some evidence of myocardial involvement [1-4]. There are several mechanisms responsible for myocardial injury, including direct viral myocardial invasion, inflammation, thrombosis, vasculitis, myocardial infarction, or secondary effects of hypoxia, tachycardia and systemic stress [1, 2, 5-7].Myocardial injury in COVID-19 may result in long-term sequelae. Healing of the initial injury may lead to myocardial fibrosis whereas in some patients, the myocardial

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Section: Limitationsmentioning

confidence: 92%

Section: Limitationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical profile and the extent of residual myocardial dysfunction among patients with previous coronavirus disease 2019

Bansal

2023

Int J Cardiovasc Imaging

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Changes of biventricular contractile function depending on the types of left ventricular involvement in patients 1 year after COVID-19 pneumonia

Shirokov,

Yaroslavskaya,

Krinochkin

et al. 2023

Russ J Cardiol

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Aim. To study the changes of biventricular contractile function depending on the types of left ventricular involvement according to the speckle tracking echocardiography (STE).Material and methods. Of the 380 patients from the Prospective Registry of People Survived COVID-19 Pneumonia, the study included 85 patients, which can be followed-up — 3 months (visit 1) and 12 months (visit 2) after COVID-19 pneumonia (men — 68,2%; mean age — 50,6±10,9 years).At visit 2, patients with diffuse left ventricle (LV) involvement according to STE (visual involvement of ≥4 segments of the same LV level) comprised group I (n=27), patients with regional LV involvement (≥3 segments corresponding to anterior, circumflex or right coronary arteries) — group II (n=39), patients without visual LV involvement — group III (n=19).Results. The groups were comparable in main clinical, functional and echocardiographic (conventional) parameters 3 and 12 months after COVID-19 pneumonia, with the exception of sex and body mass index. STE in group I showed a significant decrease in global longitudinal strain (GLS) (-18,0±2,0% at visit 1 and -16,9±1,4% at visit 2, p=0,025) and LS of all LV levels; in group II — an increase in right ventricular free wall strain (RV FWS) (-22,8±3,2% and -24,0±2,6%, respectively, p=0,006); in group III — an increase in GLS (-19,3±2,3% and -21,2±1,9%, p=0,005), LS of basal and medium LV levels, RV FWS (-23,3±2,9% and -25,0±3,0%, p=0,033). In group I, a significant increase in affected LV segments was revealed (7,0 [5,0;9,0] and 9,0 [7,0;10,0], p=0,010), while in group III there was a decrease in their number (5,0 [3,0;6,0] and 10,0 [1,0;2,0], p<0,001). According to logistic regression, LV basal LS at visit 1 (odds ratio 0,420; 95% confidence interval 0,273-0,644; p<0,001) had an independent association with diffuse LV involvement at visit 2. When it decreases, <15,8% sensitivity and the specificity of this model in predicting diffuse LV involvement was 74,1% and 74,1%, respectively (AUC=0,807; p<0,001).Conclusion. Patients with diffuse LV involvement according to STE are characterized by suppression of global biventricular contractile function during 1-year follow-up.

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Relationship between latent left ventricular contractile dysfunction and signs of immune inflammation in patients with COVID-19 pneumonia

Shirokov

Yaroslavskaya

Krinochkin

et al. 2023

Cardiovasc Ther Prev

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Aim. To investigate the relationship between echocardiographic parameters and laboratory immune inflammation signs in patients after coronavirus disease 2019 (COVID-19) pneumonia depending on the left ventricular (LV) involvement according to speckle tracking echocardiography (STE).Material and methods. The study included 216 patients (men, 51,1%, mean age, 50,1±11,1 years). The examination was carried out in patients 3 months after COVID-19 pneumonia. Patients were divided in 3 groups: group I (n=41) — diffuse decrease (≥4 segments the same LV level) of longitudinal strain (LS) according to STE; group II (n=67) — patients with regional decrease (LS reduction ≥3 segments corresponding to systems of the anterior, circumflex or right coronary arteries); group III — patients without visual left ventricle involvement (n=108).Results. There were no significant differences in LV ejection fraction — 68,9±4,1% in group I, 68,5±4,4% in group II and 68,6±4,3 in group III (p=0,934). A decrease in the global longitudinal left ventricle strain was detected significantly more often in groups I and II compared with group III (-17,8±2,0, -18,5±2,0 and -20,8±1,8%, respectively; p<0,001). At the same time, LS depression of LV basal level (-14,9±1,5, -16,8±1,2% and -19,1±1,7%; p<0,001), as well as a decrease in LS of LV inferior-posterior segments in group with diffuse involvement was detected significantly more often than in groups II and III. In addition, we revealed a significant difference in interleukin-6 concentration — 3,1 [2,5;4,0], 3,1 [2,4;3,8] and 2,5 [3,8;1,7] pg/ml, (p=0,033), C-reactive protein — 4,0 [2,2;7,9], 5,7 [3,2;7,9] and 2,4 [1,1;4,7] mg/l, (p<0,001), tumor necrosis factor-a — 5,9±1,9, 6,2±1,9 and 5,2±2,0 pg/ml, (p=0,004) and ferritin — 130,7 [56,5;220,0], 92,2 [26,0;129,4] and 51,0 [23,2;158,9] pg/l, respectively (p=0,025).Conclusion. A relationship was found between diffuse and regional left ventricular involvement according to STE and signs of immune inflammation in patients 3 months after COVID-19 pneumonia.

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Cardiac Involvement in Patients Recovered From COVID-19 Identified Using Left Ventricular Longitudinal Strain

Cited by 4 publications

References 25 publications

Clinical profile and the extent of residual myocardial dysfunction among patients with previous coronavirus disease 2019

Clinical profile and the extent of residual myocardial dysfunction among patients with previous coronavirus disease 2019

Changes of biventricular contractile function depending on the types of left ventricular involvement in patients 1 year after COVID-19 pneumonia

Relationship between latent left ventricular contractile dysfunction and signs of immune inflammation in patients with COVID-19 pneumonia

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