Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19

Abstract

Long coronavirus disease 2019 (COVID-19) was described in patients recovering from COVID-19, with dyspnea being a frequent symptom. Data regarding the potential mechanisms of long COVID remain scarce. We investigated the presence of subclinical cardiac dysfunction, assessed by transthoracic echocardiography (TTE), in recovered COVID-19 patients with or without dyspnea, after exclusion of previous cardiopulmonary diseases. A total of 310 consecutive COVID-19 patients were prospectively included. Of those, 66 patients (mean age 51.3 ± 11.1 years, almost 60% males) without known cardiopulmonary diseases underwent one-year follow-up consisting of clinical evaluation, spirometry, chest computed tomography, and TTE. From there, 23 (34.8%) patients reported dyspnea. Left ventricle (LV) ejection fraction was not significantly different between patients with or without dyspnea (55.7 ± 4.6 versus (vs.) 57.6 ± 4.5, p = 0.131). Patients with dyspnea presented lower LV global longitudinal strain, global constructive work (GCW), and global work index (GWI) compared to asymptomatic patients (−19.9 ± 2.1 vs. −21.3 ± 2.3 p = 0.039; 2183.7 ± 487.9 vs. 2483.1 ± 422.4, p = 0.024; 1960.0 ± 396.2 vs. 2221.1 ± 407.9, p = 0.030). GCW and GWI were inversely and independently associated with dyspnea (p = 0.035, OR 0.998, 95% CI 0.997–1.000; p = 0.040, OR 0.998, 95% CI 0.997–1.000). Persistent dyspnea one-year after COVID-19 was present in more than a third of the recovered patients. GCW and GWI were the only echocardiographic parameters independently associated with symptoms, suggesting a decrease in myocardial performance and subclinical cardiac dysfunction.

Impaired left ventricular deformation and ventricular-arterial coupling in post-COVID-19: association with autonomic dysregulation

“…Of interest is also the recovery of LV GLS over time and as we have documented left ventricular function is improved for at least 6-month post hospital discharge. However, it should be noted that the presence of long COVID-19 syndrome may indicate the persistence of deformation abnormalities beyond 6 months, as we and others have shown [22]. Importantly, VAC may be more relevant regarding the association with symptoms, since it represents the ratio or the balance between the pump function of the heart and the load opposed by the arterial system [23].…”

Long-Term Cardiovascular and Cerebrovascular Challenges Posed by COVID-19 in Patients With Familial Hypercholesterolemia

“…One potentially interesting cause of dyspnea due to COVID-19 was found in patients without a known pre-existing cardiopulmonary disease (mean age 51 ± 11 years), and who underwent a 1-year intensive clinical follow-up ( Luchian et al, 2022 ). All of the patients had persistent dyspnea, and in more than a third, the echocardiographic evaluation revealed significant changes in cardiac global constructive work and global work index, suggesting that these patients had decreased myocardial performance and a subclinical cardiac dysfunction.…”

Tendentious Paper—Titles and Wrong Conclusions Lead to Fear in the Population and Medical Overconsumption. Comment on Luchian et al. Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19. Diagnostics 2022, 12, 57

“…This week I read a press release from the University Hospital of Brussels with the title “30% of hospitalised COVID-19 patients have a heart defect one year after acute illness”. It is based on an article by ML Luchian [ 1 ]. The title of the article also claims “Subclinical Myocardial Dysfunction”.…”