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Eur Heart J Cardiovasc Imaging
. 2021 Sep 20;jeab190.
doi: 10.1093/ehjci/jeab190. Online ahead of print.
Evolution of right and left ventricle routine and speckle-tracking echocardiography in patients recovering from coronavirus disease 2019: a longitudinal study
Guy Baruch 1 2 , Ehud Rothschild 1 2 , Sapir Sadon 1 , Yishay Szekely 1 , Yael Lichter 3 , Alon Kaplan 2 , Philippe Taieb 1 , Ariel Banai 1 , Aviram Hochstadt 1 , Ilan Merdler 1 , Yaron Arbel 1 , Michal Laufer-Perl 1 , Gil Beer 4 , Livia Kapusta 4 5 , Yan Topilsky 1
Affiliations
- PMID: 34542601
- DOI: 10.1093/ehjci/jeab190
Abstract
Aims: We aim to assess changes in routine echocardiographic and longitudinal strain parameters in patients recovering from Coronavirus disease 2019 during hospitalization and at 3-month follow-up.
Methods and results: Routine comprehensive echocardiography and STE of both ventricles were performed during hospitalization for acute coronavirus disease 2019 (COVID-19) infection as part of a prospective pre-designed protocol and compared with echocardiography performed ∼3 months after recovery in 80 patients, using a similar protocol. Significantly improved right ventricle (RV) fractional area change, longer pulmonary acceleration time, lower right atrial pressure, and smaller RV end-diastolic and end-systolic area were observed at the recovery assessment (P < 0.05 for all). RV global longitudinal strain improved at the follow-up evaluation (23.2 ± 5 vs. 21.7 ± 4, P = 0.03), mostly due to improvement in septal segments. Only eight (10%) patients recovering from COVID-19 infection had abnormal ejection fraction (EF) at follow-up. However, LV related routine (E, E/e', stroke volume, LV size), or STE parameters did not change significantly from the assessment during hospitalization. A significant proportion [36 (45%)] of patients had some deterioration of longitudinal strain at follow-up, and 20 patients (25%) still had abnormal LV STE ∼3 months after COVID-19 acute infection.
Conclusion: In patients previously discharged from hospitalization due to COVID-19 infection, RV routine echocardiographic and RV STE parameters improve significantly concurrently with improved RV haemodynamics. In contrast, a quarter of patients still have LV systolic dysfunction based on STE cut-offs. Moreover, LV STE does not improve significantly, implying subclinical LV dysfunction may be part and parcel of recovering from COVID-19 infection.
Keywords: COVID-19; myocardial dysfunction; strain.