Abstract
IntroductionCoronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients. But a question still remains unanswered: speckle-tracking echocardiography might also be suitable to detect residual myocardial involvement after acute stage of COVID-19?Methods and resultsWe studied 100 patients recovered from COVID-19 with STE to evaluate global (GLS) and segmentar longitudinal strain (LS) and compared with a control group of 100 healthy individuals. STE was performed at a median of 130.35 ± 76.06 days after COVID-19 diagnostic. Demographic and echocardiographic parameters are similar in both groups. Left ventricular ejection faction (LVEF) and GLS were normal in COVID-19 patients (66.20 ± 1.98% and − 19.51 ± 2.87%, respectively). A reduction in mean LS for the basal segments was found in COVID-19 (16.48 ± 5.41%) when compared to control group (19.09 ± 4.31%) (p < 0.001).ConclusionThe present study suggests that COVID-19-induced cardiac involvement could persist after recovery of the disease and may be detected by deformation abnormalities using STE. COVID-19-induced myocardial involvement often shows specific LV deformation patterns due to pronounced edema and/or myocardial damage in basal LV segments.
Highlights
Coronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients
A hundred patients with recovered COVID-19 underwent STE, with 1633 (96.06%) myocardial segments of a total of 1700 segments included in the analysis; 67 (3.94%) were excluded for poor quality of imaging (29 basal segments, 25 medium segments and 13 apical segments)
No history of cardiopathy or pulmonary disease prior to COVID-19 was described in this group
Summary
Coronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients. Myocardial injury, characterized by cardiac biomarkers elevation and/or abnormalities on transthoracic echocardiography and cardiac magnetic resonance imaging have been yet reported in hospitalized COVID-19 patients [2, 5,6,7,8,9]. This myocardial damage can be caused directly by SARSCoV-2 virus or by immunopathological sequelae of myocardial inflammation [10,11,12] and is associated with adverse outcomes and increased mortality [2, 7, 13, 14]. We suspected that systemic inflammation and hypoxemia may cause secondary myocardial injury in COVID-19
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