Mitral Annular Plane Systolic Excursion: An Early Marker of Subclinical Left Ventricular Function in COVID-19 Survivors

Abstract

Introduction: The left ventricular (LV) function can be affected by COVID-19. Mitral annular plane systolic excursion (MAPSE) is a measurement that reflects the function of the LV. The association between MAPSE and LV function in COVID-19 survivors is not well understood, and this study aimed to explore that relationship. Material and methods: The retrospective cross-sectional study comprised 99 patients with a history of SARS-CoV-2 infection. These patients experienced symptoms lasting more than 2 months following the initial SARS-CoV-2 virus infection, including fatigue, shortness of breath, chest pain, and cough. The patients were categorized into two groups based on their MAPSE measurements: those with low MAPSE (<12 mm) and those with non-low MAPSE (>12 mm). MAPSE measurements were acquired using transthoracic echocardiography (TTE). Results: COVID-19 patients with low MAPSE, global longitudinal strain (GLS) (%) ([-17.61±0.95] - [-18.90±1.08], p <0.001) and mitral E/A ratio ([0.83±0.39] - [0.97±0.23], p = 0.028) were statistically significant compared to the the group without low MAPSE. Left atrial volume index (LAVI) in mm/m2 ([37.24±2.11] - [35.34±2.50], p =0.001) was higher in the group of COVID-19 patients with lower MAPSE. High-sensitivity troponin T (Hs-TnT) (OR: 2.019, 95% CI: 1.043-3.712, p =0.028), intensive care unit (ICU) admission (OR: 1.432, 95% CI: 1.004-2.708, p =0 .037) and need for invasive mechanical ventilation (IMV) support (OR: 1.306, 95% CI: 1.128-2.630, p =0.004) were identified as independent predictors of reduced MAPSE. Conclusions: SARS-CoV-2 infection may lead to reduced or impaired MAPSE values, indicative of impaired LV function, in COVID-19 survivors. Additionally, our study revealed that elevated levels of (Hs-TnT), admission to the ICU, and the need for IMV support were predictive factors for low MAPSE values. These findings underscore the potential cardiac implications of COVID-19 and highlight the importance of monitoring cardiac function in patients with severe disease manifestations.