Lower left ventricular cardiac strain in patients who recovered from COVID-19

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health of the Czech Republic. Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes the highly contagious coronavirus disease 2019 (COVID-19). This disease has been linked to several cardiac problems. Studying heart deformation with cardiovascular magnetic resonance feature-tracking (CMR-FT) might help detect subtle systolic or diastolic dysfunction in patients who recovered from COVID-19. Purpose We aimed to characterize the left ventricular strain in patients who recovered from COVID-19 by using cardiovascular magnetic resonance feature tracking (CMR-FT). Methods In this study, we compared a cohort of 55 patients who recovered from COVID-19 (age 48 ± 16 years, time between diagnosis and CMR 46 (34 to 166) days) to 44 sex- and age-matched control subjects (age 47 ± 16 years) with a CMR examination before March 1st, 2020. All the participants were examined in our hospital. By using CMR-FT, we determined the left ventricle (LV) global circumferential strain (GCS), global longitudinal strain (GLS), and global radial strain (GRS). LV clinical parameters were indexed to the body surface area. The student's t-test and Wilcoxon rank-sum test were used to compare normally and non-normally distributed variables. The adjusted P-value was obtained by using a false discovery rate correction. Results Although the left ventricular ejection fraction was significantly lower in patients who recovered from COVID-19 than in controls (64 (60 to 70) % vs. 68 (64 to 73) %, P-value = 0.022), the former had normal systolic LV function. At the same time, they had higher LV end-systolic indexed volume (23.0 (15.4 to 30.4) ml/m2 vs. 19.4 (15.2 to 24.4) ml/m2, P-value = 0.048). Regarding the global LV strain, all parameters were significantly lower in the patients who recovered from COVID-19 than in controls (GCS −17.1 (−18.4 to −15.4) % vs. −18.1 (−19.7 to −17.0) %, P-value = 0.004; GLS −17.3 (−18.7 to −15.6) % vs. −18.2 (−19.3 to −16.9) %, P-value = 0.011; GRS 28.1 (23.8 to 31.8) % vs. 31.6 (28.4 to 34.3) %, P-value = 0.004). Conclusion Compared to controls, patients who recovered from COVID-19 exhibit lower global left ventricular strain values assessed by CMR-FT.