tetano
Editor, Senior Moderator
Echocardiography
. 2023 Apr 26.
doi: 10.1111/echo.15575. Online ahead of print.
Long-term prognostic impact of subclinical myocardial dysfunction in patients recovered from COVID-19
Francesco Cannata[SUP] 1 2 [/SUP], Giuseppe Pinto[SUP] 1 [/SUP], Mauro Chiarito[SUP] 1 2 [/SUP], Matteo Maurina[SUP] 1 2 [/SUP], Francesco Condello[SUP] 1 2 [/SUP], Sara Bombace[SUP] 1 2 [/SUP], Alessandro Villaschi[SUP] 1 2 [/SUP], Laura Novelli[SUP] 1 2 [/SUP], Kamil Stankowski[SUP] 1 2 [/SUP], Gaetano Liccardo[SUP] 1 2 [/SUP], Gaia Gasparini[SUP] 1 2 [/SUP], Dario Donia[SUP] 1 2 [/SUP], Anastasia Celata[SUP] 1 2 [/SUP], Ilaria My[SUP] 1 3 [/SUP], Marinos Kallikourdis[SUP] 2 [/SUP], Stefano Figliozzi[SUP] 1 [/SUP], Riccardo Mantovani[SUP] 1 [/SUP], Fabio Fazzari[SUP] 1 4 [/SUP], Renato M Bragato[SUP] 1 [/SUP], Gianluigi Condorelli[SUP] 1 2 [/SUP], Giulio G Stefanini[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Cardiovascular sequelae may occur in patients recovered from coronavirus disease 2019 (COVID-19). Recent studies have detected a considerable incidence of subclinical myocardial dysfunction-assessed with speckle-tracking echocardiography-and of long-COVID symptoms in these patients. This study aimed to define the long-term prognostic role of subclinical myocardial dysfunction and long-COVID condition in patients recovered from COVID-19 pneumonia.
Methods: We prospectively followed up 110 patients hospitalized at our institution due to COVID-19 pneumonia in April 2020 and then recovered from SARS-CoV-2 infection. A 7-month clinical and echocardiographic evaluation was performed, followed by a 21-month clinical follow-up. The primary outcome was major adverse cardiovascular events (MACE), a composite of myocardial infarction, stroke, heart failure hospitalization, and all-cause mortality.
Results: A subclinical myocardial dysfunction-defined as an impairment of left ventricular global longitudinal strain (≥-18%)-was identified at a 7-month follow-up in 37 patients (34%), was associated with an increased risk of long-term MACE with a good discriminative power (area under the curve: .73) and resulted in a strong independent predictor of extended MACE in multivariate regression analyses. Long-COVID condition was not associated with a worse long-term prognosis, instead.
Conclusions: In patients recovered from COVID-19 pneumonia, a subclinical myocardial dysfunction is present in one-third of the whole population at 7-month follow-up and is associated with a higher risk of MACE at long-term follow-up. Speckle-tracking echocardiography is a promising tool to optimize the risk-stratification in patients recovered from COVID-19 pneumonia, while the definition of a long-COVID condition has no prognostic relevance.
Keywords: COVID-19; advanced echocardiography; global longitudinal strain; long-COVID; subclinical myocardial dysfunction.
. 2023 Apr 26.
doi: 10.1111/echo.15575. Online ahead of print.
Long-term prognostic impact of subclinical myocardial dysfunction in patients recovered from COVID-19
Francesco Cannata[SUP] 1 2 [/SUP], Giuseppe Pinto[SUP] 1 [/SUP], Mauro Chiarito[SUP] 1 2 [/SUP], Matteo Maurina[SUP] 1 2 [/SUP], Francesco Condello[SUP] 1 2 [/SUP], Sara Bombace[SUP] 1 2 [/SUP], Alessandro Villaschi[SUP] 1 2 [/SUP], Laura Novelli[SUP] 1 2 [/SUP], Kamil Stankowski[SUP] 1 2 [/SUP], Gaetano Liccardo[SUP] 1 2 [/SUP], Gaia Gasparini[SUP] 1 2 [/SUP], Dario Donia[SUP] 1 2 [/SUP], Anastasia Celata[SUP] 1 2 [/SUP], Ilaria My[SUP] 1 3 [/SUP], Marinos Kallikourdis[SUP] 2 [/SUP], Stefano Figliozzi[SUP] 1 [/SUP], Riccardo Mantovani[SUP] 1 [/SUP], Fabio Fazzari[SUP] 1 4 [/SUP], Renato M Bragato[SUP] 1 [/SUP], Gianluigi Condorelli[SUP] 1 2 [/SUP], Giulio G Stefanini[SUP] 1 2 [/SUP]
Affiliations
- PMID: 37100745
- DOI: 10.1111/echo.15575
Abstract
Background: Cardiovascular sequelae may occur in patients recovered from coronavirus disease 2019 (COVID-19). Recent studies have detected a considerable incidence of subclinical myocardial dysfunction-assessed with speckle-tracking echocardiography-and of long-COVID symptoms in these patients. This study aimed to define the long-term prognostic role of subclinical myocardial dysfunction and long-COVID condition in patients recovered from COVID-19 pneumonia.
Methods: We prospectively followed up 110 patients hospitalized at our institution due to COVID-19 pneumonia in April 2020 and then recovered from SARS-CoV-2 infection. A 7-month clinical and echocardiographic evaluation was performed, followed by a 21-month clinical follow-up. The primary outcome was major adverse cardiovascular events (MACE), a composite of myocardial infarction, stroke, heart failure hospitalization, and all-cause mortality.
Results: A subclinical myocardial dysfunction-defined as an impairment of left ventricular global longitudinal strain (≥-18%)-was identified at a 7-month follow-up in 37 patients (34%), was associated with an increased risk of long-term MACE with a good discriminative power (area under the curve: .73) and resulted in a strong independent predictor of extended MACE in multivariate regression analyses. Long-COVID condition was not associated with a worse long-term prognosis, instead.
Conclusions: In patients recovered from COVID-19 pneumonia, a subclinical myocardial dysfunction is present in one-third of the whole population at 7-month follow-up and is associated with a higher risk of MACE at long-term follow-up. Speckle-tracking echocardiography is a promising tool to optimize the risk-stratification in patients recovered from COVID-19 pneumonia, while the definition of a long-COVID condition has no prognostic relevance.
Keywords: COVID-19; advanced echocardiography; global longitudinal strain; long-COVID; subclinical myocardial dysfunction.