Association of right and left atrial strain with laboratory, anthropometric and echocardiographic markers - the influence of COVID-19 pandemic

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Centre of Science. Background The exploration for the impact of surviving a coronavirus disease of 2019 (COVID-19) on the cardiovascular system and cause-and-effect relationships is still a challenge for researchers. Purpose The aim of the study was to evaluate the parameters of right and left atrial deformation using strain imaging in echocardiography (ECHO) among undergoing COVID-19, their relationship to the survival of this disease, and to investigate whether there is a relationship between these parameters and laboratory, anthropometric and echocardiographic markers. Methods The study consisted of 134 patients of the study group - subjects examined 6-9 months after hospitalisation due to COVID-19 infection, and 134 control subjects - participants of the Bialystok PLUS project, examined before the pandemic (the assumed start date of the pandemic in Poland is 18 March 2020). The groups were matched for age and gender. In all subjects, an extensive medical history was taken, anthropometric measurements, a comprehensive panel of laboratory tests, blood pressure, pulse wave velocity (PWV) were measured. ECHO was performed including assessment of right (RA) and left atrial (LA) strain parameters. Results Individuals after COVID-19 had significantly lower RA strain parameters, such as: global longitudinal strain (40.5±13.8% vs. control group 47.2±13.4%, p<0.000) and global circumferential strain (26.9±16.5% vs. 32.8±16.5%, p=0.014), while no differences were found for LA strain. Significantly lower values of parameters characterising LV diastolic function, i.e. E/A (p=0.003) and septal e' velocity (p=0.012), were also observed in COVID survivors. Troponin (hs-TnT) (p<0.000) and CRP protein (hs-CRP) (p=0.011) levels were significantly higher in the survivors group, while total cholesterol (p=0.001) and LDL fractions (p<0.000) were significantly lower. Subjects after COVID-19 also had significantly higher neck, waist, hip circumferences (p=0.013; p=0.045, p=0.001 respectively) and body mass index (BMI) (p=0.045). The groups did not differ in metabolic markers (fasting glucose, glycated haemoglobin, HOMA-IR index). A multivariate linear regression analysis was conducted to assess which parameters might be related to the RA strain parameters. The results were shown in the table 1. Conclusions COVID-19 infection results in worsening of right atrial strain parameters. This phenomenon requires deeper analysis.