tetano
Editor, Senior Moderator
Echocardiography
. 2021 Oct 21.
doi: 10.1111/echo.15215. Online ahead of print.
Subclinical myocardial dysfunction in patients recovered from COVID-19
Leonardo Italia[SUP] 1 [/SUP], Giacomo Ingallina[SUP] 1 [/SUP], Antonio Napolano[SUP] 1 [/SUP], Antonio Boccellino[SUP] 1 [/SUP], Martina Belli[SUP] 1 [/SUP], Francesco Cannata[SUP] 1 [/SUP], Marco Rolando[SUP] 1 [/SUP], Francesco Ancona[SUP] 1 [/SUP], Francesco Melillo[SUP] 1 [/SUP], Stefano Stella[SUP] 1 [/SUP], Marco Ripa[SUP] 2 [/SUP], Paolo Scarpellini[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 3 [/SUP], Alessandro Ortalda[SUP] 4 [/SUP], Beatrice Righetti[SUP] 4 [/SUP], Francesco De Cobelli[SUP] 5 6 [/SUP], Antonio Esposito[SUP] 5 6 [/SUP], Fabio Ciceri[SUP] 5 7 [/SUP], Antonella Castagna[SUP] 2 5 [/SUP], Patrizia Querini Rovere[SUP] 5 8 [/SUP], Gabriele Fragasso[SUP] 9 [/SUP], Eustachio Agricola[SUP] 1 5 [/SUP]
Affiliations
Abstract
Background: Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography.
Methods: This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed.
Results: The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1± .3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure.
Conclusions: In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.
Keywords: COVID-19; echocardiography; heart failure; myocarditis; strain.
. 2021 Oct 21.
doi: 10.1111/echo.15215. Online ahead of print.
Subclinical myocardial dysfunction in patients recovered from COVID-19
Leonardo Italia[SUP] 1 [/SUP], Giacomo Ingallina[SUP] 1 [/SUP], Antonio Napolano[SUP] 1 [/SUP], Antonio Boccellino[SUP] 1 [/SUP], Martina Belli[SUP] 1 [/SUP], Francesco Cannata[SUP] 1 [/SUP], Marco Rolando[SUP] 1 [/SUP], Francesco Ancona[SUP] 1 [/SUP], Francesco Melillo[SUP] 1 [/SUP], Stefano Stella[SUP] 1 [/SUP], Marco Ripa[SUP] 2 [/SUP], Paolo Scarpellini[SUP] 2 [/SUP], Moreno Tresoldi[SUP] 3 [/SUP], Alessandro Ortalda[SUP] 4 [/SUP], Beatrice Righetti[SUP] 4 [/SUP], Francesco De Cobelli[SUP] 5 6 [/SUP], Antonio Esposito[SUP] 5 6 [/SUP], Fabio Ciceri[SUP] 5 7 [/SUP], Antonella Castagna[SUP] 2 5 [/SUP], Patrizia Querini Rovere[SUP] 5 8 [/SUP], Gabriele Fragasso[SUP] 9 [/SUP], Eustachio Agricola[SUP] 1 5 [/SUP]
Affiliations
- PMID: 34672005
- DOI: 10.1111/echo.15215
Abstract
Background: Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography.
Methods: This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed.
Results: The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1± .3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure.
Conclusions: In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.
Keywords: COVID-19; echocardiography; heart failure; myocarditis; strain.