Relationship between latent left ventricular contractile dysfunction and signs of immune inflammation in patients with COVID-19 pneumonia

Abstract

Aim. To investigate the relationship between echocardiographic parameters and laboratory immune inflammation signs in patients after coronavirus disease 2019 (COVID-19) pneumonia depending on the left ventricular (LV) involvement according to speckle tracking echocardiography (STE).Material and methods. The study included 216 patients (men, 51,1%, mean age, 50,1±11,1 years). The examination was carried out in patients 3 months after COVID-19 pneumonia. Patients were divided in 3 groups: group I (n=41) — diffuse decrease (≥4 segments the same LV level) of longitudinal strain (LS) according to STE; group II (n=67) — patients with regional decrease (LS reduction ≥3 segments corresponding to systems of the anterior, circumflex or right coronary arteries); group III — patients without visual left ventricle involvement (n=108).Results. There were no significant differences in LV ejection fraction — 68,9±4,1% in group I, 68,5±4,4% in group II and 68,6±4,3 in group III (p=0,934). A decrease in the global longitudinal left ventricle strain was detected significantly more often in groups I and II compared with group III (-17,8±2,0, -18,5±2,0 and -20,8±1,8%, respectively; p<0,001). At the same time, LS depression of LV basal level (-14,9±1,5, -16,8±1,2% and -19,1±1,7%; p<0,001), as well as a decrease in LS of LV inferior-posterior segments in group with diffuse involvement was detected significantly more often than in groups II and III. In addition, we revealed a significant difference in interleukin-6 concentration — 3,1 [2,5;4,0], 3,1 [2,4;3,8] and 2,5 [3,8;1,7] pg/ml, (p=0,033), C-reactive protein — 4,0 [2,2;7,9], 5,7 [3,2;7,9] and 2,4 [1,1;4,7] mg/l, (p<0,001), tumor necrosis factor-a — 5,9±1,9, 6,2±1,9 and 5,2±2,0 pg/ml, (p=0,004) and ferritin — 130,7 [56,5;220,0], 92,2 [26,0;129,4] and 51,0 [23,2;158,9] pg/l, respectively (p=0,025).Conclusion. A relationship was found between diffuse and regional left ventricular involvement according to STE and signs of immune inflammation in patients 3 months after COVID-19 pneumonia.