Left ventricular global longitudinal strain in low cardiac risk outpatients who recently recovered from coronavirus disease 2019

Abstract

The cardiac sequelae of coronavirus disease 2019 , a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.

Myocardial work and vascular dysfunction are partially improved at 12 months after COVID‐19 infection

“…Coronavirus disease 2019 (COVID‐19) has been proved as a multi‐organ disease with deleterious effect on the cardiovascular system 1 . COVID‐19 infection has been associated with impaired subclinical markers of cardiovascular and endothelial function even in patients with mild severity of COVID‐19 2 . Furthermore, subclinical myocardial and vascular dysfunction during COVID‐19 disease have been associated with worse outcomes and higher mortality risk 3 …”

“…1 COVID-19 infection has been associated with impaired subclinical markers of cardiovascular and endothelial function even in patients with mild severity of COVID-19. 2 Furthermore, subclinical myocardial and vascular dysfunction during COVID-19 disease have been associated with worse outcomes and higher mortality risk. 3 Carotid-femoral pulse wave velocity (PWVc-f) and central systolic blood pressure (SBPcentral) are reliable markers of aortic elastic properties and have been suggested as valuable prognostic markers for cardiovascular events.…”

Cardiovascular Complications of Pregnancy-Associated COVID-19 Infections

“… 64 , 65 , 66 , 67 Evidence of myocarditis, persistent myocardial inflammation, or subclinical myocardial injury can be seen months following acute COVID infection. 33 , 67 , 68 …”

The Evolving Role of Echocardiography During the Coronavirus Disease 2019 Pandemic

“…Furthermore, there is evidence that even asymptomatic patients who were not hospitalized for COVID-19 infection had a significantly lower absolute value of LV GLS at followup (median: 23 [interquartile range: 11-89] days) compared with healthy controls 58. This study excluded patients with COVID-19 who had abnormal electrocardiography, LVEF <50%, severe valvular heart disease or pre-existing cardiovascular disease, suggesting that the abnormal LV GLS at follow-up was likely to be related to COVID-19 infection and not a result of underlying comorbidities.…”