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

Abstract

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.