Hidden Danger of COVID-19 Outbreak: Evaluation of Subclinical Myocardial Dysfunction in Patients with Mild Symptoms

Gül, Murat; İnci, Sinan; Aktaş, Halil; Yıldırım, Oğuz; Alsancak, Yakup

doi:10.21203/rs.3.rs-412750/v1

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Ikonomidis et al could show an improved aortic function in 60 individuals after bariatric surgery (Ikonomidis et al, 2007). Similarly, Gul et al observed an improvement of aortic stiffness 1 year after laparoscopic sleeve gastrectomy in 53 obese individuals (Gul et al, 2021). Also, Brinkley et al could demonstrate an improved aortic stiffness in elderly obese after moderate and intensive caloric restriction combined with aerobic exercise training, but not with aerobic exercise training alone (Brinkley et al, 2021).…”

Section: Discussionmentioning

confidence: 98%

Changes in aortic diameter induced by weight loss: The HELENA trial- whole-body MR imaging in a dietary intervention trial

et al. 2022

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Obesity-related metabolic disorders such as hypertension, hyperlipidemia and chronic inflammation have been associated with aortic dilatation and resulting in aortic aneurysms in many cases. Whether weight loss may reduce the risk of aortic dilatation is not clear. In this study, the diameter of the descending thoracic aorta, infrarenal abdominal aorta and aortic bifurcation of 144 overweight or obese non-smoking adults were measured by MR-imaging, at baseline, and 12 and 50 weeks after weight loss by calorie restriction. Changes in aortic diameter, anthropometric measures and body composition and metabolic markers were evaluated using linear mixed models. The association of the aortic diameters with the aforementioned clinical parameters was analyzed using Spearman`s correlation. Weight loss was associated with a reduction in the thoracic and abdominal aortic diameters 12 weeks after weight loss (predicted relative differences for Quartile 4: 2.5% ± 0.5 and -2.2% ± 0.8, p < 0.031; respectively). Furthermore, there was a nominal reduction in aortic diameters during the 50-weeks follow-up period. Aortic diameters were positively associated with weight, visceral adipose tissue, glucose, HbA1c and with both systolic and diastolic blood pressure. Weight loss induced by calorie restriction may reduce aortic diameters. Future studies are needed to investigate, whether the reduction of aortic diameters via calorie restriction may help to prevent aortic aneurysms.

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Section: Discussionmentioning

confidence: 98%

Changes in aortic diameter induced by weight loss: The HELENA trial- whole-body MR imaging in a dietary intervention trial

et al. 2022

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COVID-19 Pnömonili Hastaların Taburculuk Sonrası Sağ Ventrikül Fonksiyonunun Sağ Ventriküler Erken Giriş-Çıkış İndeksi ile Değerlendirilmesi

Günay¹

2022

Archives of Clinical and Experimental Medicine

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Aim: The coronavirus disease 2019 (COVID-19) has been causing many cardiovascular complications. In patients with comorbidities, COVID-19 infection has a more severe course. Even with some patients who do not have comorbidities, severe infection and death may occur. In studies, many echocardiographic parameters were found to be impaired in patients with COVID-19 pneumonia. The right ventricle early inflow-outflow (RVEIO) index is a possible and indirect predictor of the severity of right ventricle dysfunction. The aim of our study is to evaluate the RVEIO index after discharge in patients with moderate-to-severe COVID-19 pneumonia without comorbidities. Methods: The study was conducted prospectively in a single center. One month after discharge, echocardiography and biochemical tests were performed in 57 patients with moderate-to-severe COVID-19 pneumonia without comorbidities. Results: Pulmonary artery diameter was found to be significantly larger in the severe group [1.9 (1.8-2) vs. 2 (1.9-2.1); p=0.014]. Pulmonary artery acceleration time [140.92±11.70 vs 114.58±12.03; p=0.001)] and RVOT VTI [23.48±1.96 vs 19.18±2.2; p <0.001] was significantly lower, while the RVEIO index was [2.51±0.54 vs 3.22±0.92; p<0.001] was found to be significantly higher in the severe group. Conclusion: The long-term effects of COVID-19 infection are still unknown. Therefore, follow-up studies should be conducted. Echocardiography can be used in the follow-up of inpatients and discharged patients because of its easy accessibility and low cost. Long-term follow-up should be conducted for individuals who had a severe COVID-19 pneumonia and who do not have comorbidities. The RVEIO index may be used in the follow-ups.

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Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity

Shimoni

Korenfeld

Goland

et al. 2021

Biology

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Aims: Myocardial abnormalities are common during COVID-19 infection and recovery. We examined left (LV) and right (RV) ventricular longitudinal strain in patients who had recovered from COVID-19 and assessed the correlation with exercise capacity. Methods and results: One hundred and eighty-four consecutive patients with history of COVID-19 disease who had been referred to rest or stress echocardiography because of symptoms, mainly dyspnea and chest pain, were included in the study. These patients were compared to 106 patients with similar age, symptoms, and risk factor profile with no history of COVID-19 disease. Clinical and echocardiographic parameters, including strain imaging, were assessed. The patient’s age was 48 ± 12 years. Twenty-two patients had undergone severe disease. There were no differences in the LV ejection fraction and diastolic function between the groups. However, LV and RV global and free wall strain were significantly lower (in absolute numbers) in patients who had recovered form COVID-19 infection (−20.41 ± 2.32 vs −19.39 ± 3.36, p = 0.001, −23.69 ± 3.44 vs −22.09 ± 4.20, p = 0.001 and −27.24 ± 4.7 vs −25.43 ± 4.93, p = 0.021, respectively). Global Longitudinal Strain (GLS) < −20% was present in only 37% of post COVID-19 patients. Sixty-four patients performed exercise echocardiography. Patients with GLS < −20% had higher exercise capacity with higher peak metabolic equivalent and exercise time compared to patients with GLS ≥ −20% (12.6 ± 2 vs 10 ± 2.5 METss and 8:00 ± 2:08 vs 6:24 ± 2:03 min, p < 0.001 and p = 0.003, respectively). Conclusion: In patients, who had recovered from COVID-19 infection, both LV and RV strain are significantly lower compared to control patients. The exercise capacity of these patients correlates with LV strain values. Rest and stress echocardiography in patients with symptoms after COVID-19 infection may identify patients that need further follow up to avoid long term complications of the disease. These preliminary results warrant further research, to test the natural history of these findings and the need and timing of treatment.

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Hidden Danger of COVID-19 Outbreak: Evaluation of Subclinical Myocardial Dysfunction in Patients with Mild Symptoms

Cited by 4 publications

References 26 publications

Changes in aortic diameter induced by weight loss: The HELENA trial- whole-body MR imaging in a dietary intervention trial

Changes in aortic diameter induced by weight loss: The HELENA trial- whole-body MR imaging in a dietary intervention trial

COVID-19 Pnömonili Hastaların Taburculuk Sonrası Sağ Ventrikül Fonksiyonunun Sağ Ventriküler Erken Giriş-Çıkış İndeksi ile Değerlendirilmesi

Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity

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