Subclinical myocardial dysfunction in patients recovered from COVID‐19

Italia, Leonardo; Ingallina, Giacomo; Napolano, Antonio; Boccellino, Antonio; Belli, Martina; Cannata, F.; Rolando, Marco; Ancona, Francesco; Melillo, Francesco; Stella, Stefano; Ripa, Marco; Scarpellini, Paolo; Tresoldi, Moreno; Ortalda, Alessandro; Righetti, Beatrice; Cobelli, Francesco De; Esposito, Antonio; Ciceri, Fabio; Castagna, Antonella; Rovere, Patrizia; Fragasso, Gabriele; Agricola, Eustachio

doi:10.1111/echo.15215

Cited by 20 publications

(19 citation statements)

References 37 publications

(98 reference statements)

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“…Studies showing that biventricular diastolic functions are adversely affected in COVID-19 patients are included in the literature. [23][24][25] In a recent study, cardiac performance was followed for 6 months in hospitalized patients with COVID-19, and evidence of myocardial injury, and diastolic dysfunction was reported to be common. However, they reported that diastolic dysfunction was not affected in the 6month follow-up of COVID-19 patients without cardiac involvement.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, systolic and diastolic functions may be adversely affected. Studies showing that biventricular diastolic functions are adversely affected in COVID‐19 patients are included in the literature 23–25 …”

Section: Discussionmentioning

confidence: 99%

“…Studies showing that biventricular diastolic functions are adversely affected in COVID‐19 patients are included in the literature. 23 , 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

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Myocardial performance index increases at long‐term follow‐up in patients with mild to moderate COVID‐19

et al. 2022

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Background The long‐term cardiovascular effects of Coronavirus disease‐2019 (COVID‐19) are not yet well known. Myocardial performance index (MPI) is a non‐invasive, inexpensive and reproducible echocardiographic parameter that reflects systolic and diastolic cardiac functions. The aim of the study was to compare MPI with a healthy control group in patients with mild or moderate COVID‐19 infection who subsequently had unexplained cardiac symptoms. Methods The study included 200 patients aged 18–70 years who were diagnosed with COVID‐19 infection at least 2 months ago and defined cardiac symptoms in their follow‐up. Patients with mild or moderate symptoms, no history of hospitalization, and no other pathology that could explain cardiac symptoms were included in the study. As the control group, 182 healthy volunteers without COVID‐19 were evaluated. Echocardiographic examination was performed on the entire study group. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT), and ejection time (ET) were measured by tissue Doppler imaging. MPI was calculated with the IVCT+IVRT/ET formula. Results The mean age of the study group was 44.24 ± 13.49 years. In the patient group the MPI was significantly higher (.50 ± .11 vs .46 ± .07, p < .001), IVRT was longer (69.67 ± 15.43 vs 65.94 ± 12.03 ms, p = . 008), and ET was shorter (271.09 ± 36.61 vs 271.09 ± 36.61 ms, p = .028). IVCT was similar between groups (63.87 ± 13.66 vs. 63.21 ± 10.77 ms, p = .66). Mitral E and mitral A wave, E’, A’, and E/A were similar in both groups. Conclusions Our study showed that conventional diastolic function parameters were not affected in patients who survived COVID‐19 with mild symptoms but had symptoms in the long term. However, MPI measurements showed left ventricular dysfunction. To our knowledge, this is the first echocardiographic follow‐up study to evaluate left ventricular systolic and diastolic functions with MPI in COVID‐19 patients. We think that when cardiac involvement assessment is required in patients who have survived COVID‐19, MPI should be measured alongside other echocardiographic measurements.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Myocardial performance index increases at long‐term follow‐up in patients with mild to moderate COVID‐19

et al. 2022

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“…Ischemic injury pattern, defined as having either sub-endocardial or transmural late gadolinium enhancement (LGE) on CMR or inducible ischemia on adenosine stress test, was found in 66% of patients with no prior history of coronary disease. Another study comparing patients who developed myocardial injury, defined by high-sensitivity troponin T (hsTnT) elevation exceeding the 99th percentile, during hospitalization for COVID-19 infection versus those without myocardial injury found that patients with myocardial injury had higher frequency of impaired diastolic function, larger left atrial size, and higher values of pulmonary artery pressure at three-month follow-up as compared to the group that did not develop myocardial injury during hospitalization for COVID-19 infection [ 34 ]. Another prospective cohort study evaluating 159 patients found that at 4–9 weeks post-hospitalization for COVID-19 infection, patients recovering from COVID-19 were at greater risk of developing myocardial scarring and persistent cardio-renal dysfunction as compared to matched control [ 35 ].…”

Section: Myocardial Injury and Ischemic Heart Diseasementioning

confidence: 99%

Cardiac Manifestations of Post-Acute COVID-19 Infection

2022

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Purpose of Review There is emerging evidence that the post-acute and chronic phases of COVID-19 infection are associated with various significant cardiovascular sequelae. Recent Findings Long COVID has been shown to be associated with multiple cardiovascular sequelae including direct myocardial injury, arrhythmias, and cardiomyopathies. Hypotheses on the mechanism of myocardial injury include direct viral infiltration and autoimmune dysregulation. Long COVID is associated with persistent cardiac ischemia in patients with no previous history of coronary disease, atrial and ventricular arrhythmias, and the development of new-onset heart failure in previously healthy patients. Onset of long COVID may be related to severity of the initial SARS-CoV2 infection. Cardiac MRI is a valuable tool in assessing myocarditis and the development of cardiomyopathies in the setting of long COVID. Summary Both patients with and without pre-existing cardiovascular disease are at risk of developing myocardial injury in the setting of long COVID. Future studies will elucidate both cardiovascular mortality and cardiac rehabilitation in the post-acute and chronic phases of COVID-19.

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“…[ 23 ],[ 24 ] Occasionally, the damages can be subclinical, as evident by worse left ventricular global longitudinal strain and diastolic function in patients recovered from COVID-19 infection. [ 26 ] These may have long-term consequences given the huge number of COVID-19 survivors and the pandemic seems to be long lasting.…”

Section: Impact Of St Elevation Myocardial Infarction On Patients Suf...mentioning

confidence: 99%

Challenges in Management of ST Elevation Myocardial Infarction during COVID-19 Pandemic

2021

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The coronavirus disease-2019 (COVID-19) pandemic has brought unprecedented changes to our world and health-care system. Its high virulence and infectiousness directly infect people's respiratory system and indirectly disrupt our health-care infrastructure. In particular, ST elevation myocardial infarction (STEMI) is a clinical emergency emphasizes on the establishment of care system to minimize delay to reperfusion. As such, the impact of COVID-19 on STEMI care, ranging from disease severity, patient delay, diagnostic difficulty, triage to selection of reperfusion strategy and postoperative care, is immense. Importantly, not only we have to save our patients, but we must also need to protect all health-care workers and prevent environmental contamination. Otherwise, in-hospital transmission can quickly evolve into nosocomial outbreak with staff infection and quarantine which lead to health-care system collapse. In this article, we will discuss the challenges in various aspects of STEMI management during COVID-19, as well as the mitigation measures we can take to optimize outcome and our future.

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Subclinical myocardial dysfunction in patients recovered from COVID‐19

Cited by 20 publications

References 37 publications

Myocardial performance index increases at long‐term follow‐up in patients with mild to moderate COVID‐19

Myocardial performance index increases at long‐term follow‐up in patients with mild to moderate COVID‐19

Cardiac Manifestations of Post-Acute COVID-19 Infection

Challenges in Management of ST Elevation Myocardial Infarction during COVID-19 Pandemic

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