tetano
Editor, Senior Moderator
Echocardiography
. 2022 Jul 29.
doi: 10.1111/echo.15431. Online ahead of print.
The usefulness of speckle tracking echocardiography in identifying subclinical myocardial dysfunction in young adults recovered from mild COVID-19
Elisa Gherbesi[SUP] 1 [/SUP], Luca Bergamaschi[SUP] 1 2 [/SUP], Ignazio Cusmano[SUP] 1 [/SUP], Thien Trung Tien[SUP] 3 [/SUP], Pasquale Paolisso[SUP] 2 4 5 [/SUP], Alberto Foà[SUP] 2 [/SUP], Carmine Pizzi[SUP] 2 [/SUP], Alberto Barosi[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Myocardial strain assessed with speckle tracking echocardiography is a sensitive marker of cardiac dysfunction. Both left-ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) were affected by severe SARS-CoV-2 infection. However, data about cardiac involvement in patients with asymptomatic/mild Coronavirus disease-19 (COVID-19) is still lacking.
Aim: To evaluate myocardial function using LV-GLS and RV-LS in patients with previous asymptomatic/mild COVID-19.
Methods: Forty young adults without previously known comorbidities/cardiovascular risk factors and with a confirmed diagnosis of asymptomatic or paucisymptomatic SARS-CoV-2 infection were retrospectively included. A 2D-transthoracic echocardiogram with speckle tracking analysis was performed at least 3 months after the diagnosis. Forty healthy subjects, matched for age, sex, and body surface area in a 1:1 ratio were used as the control group.
Results: Left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE) and RV-LS were comparable between the two groups. LV-GLS was significantly lower in the cases compared to the control group (-22.7 ± 1.6% vs. -25.7 ± 2.3%; p < .001). Moreover, the prevalence of regional peak systolic strain below -16% in at least two segments was three times higher in patients with previous COVID-19 compared to controls (30% vs. 10%, p = .02). In multivariable logistic regression, previous COVID-19 infection was independently associated with reduced LV-GLS values (p < .001).
Conclusion: SARS-CoV-2 infection may affect left ventricular deformation in 30% of young adult patients despite an asymptomatic or only mildly symptomatic acute illness. Speckle-tracking echocardiography could help early identification of patients with subclinical cardiac involvement, with potential repercussions on risk stratification and management.
Keywords: COVID-19; SARS-CoV-2; myocardial strain; speckle tracking echocardiography.
. 2022 Jul 29.
doi: 10.1111/echo.15431. Online ahead of print.
The usefulness of speckle tracking echocardiography in identifying subclinical myocardial dysfunction in young adults recovered from mild COVID-19
Elisa Gherbesi[SUP] 1 [/SUP], Luca Bergamaschi[SUP] 1 2 [/SUP], Ignazio Cusmano[SUP] 1 [/SUP], Thien Trung Tien[SUP] 3 [/SUP], Pasquale Paolisso[SUP] 2 4 5 [/SUP], Alberto Foà[SUP] 2 [/SUP], Carmine Pizzi[SUP] 2 [/SUP], Alberto Barosi[SUP] 1 [/SUP]
Affiliations
- PMID: 35906710
- DOI: 10.1111/echo.15431
Abstract
Background: Myocardial strain assessed with speckle tracking echocardiography is a sensitive marker of cardiac dysfunction. Both left-ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) were affected by severe SARS-CoV-2 infection. However, data about cardiac involvement in patients with asymptomatic/mild Coronavirus disease-19 (COVID-19) is still lacking.
Aim: To evaluate myocardial function using LV-GLS and RV-LS in patients with previous asymptomatic/mild COVID-19.
Methods: Forty young adults without previously known comorbidities/cardiovascular risk factors and with a confirmed diagnosis of asymptomatic or paucisymptomatic SARS-CoV-2 infection were retrospectively included. A 2D-transthoracic echocardiogram with speckle tracking analysis was performed at least 3 months after the diagnosis. Forty healthy subjects, matched for age, sex, and body surface area in a 1:1 ratio were used as the control group.
Results: Left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE) and RV-LS were comparable between the two groups. LV-GLS was significantly lower in the cases compared to the control group (-22.7 ± 1.6% vs. -25.7 ± 2.3%; p < .001). Moreover, the prevalence of regional peak systolic strain below -16% in at least two segments was three times higher in patients with previous COVID-19 compared to controls (30% vs. 10%, p = .02). In multivariable logistic regression, previous COVID-19 infection was independently associated with reduced LV-GLS values (p < .001).
Conclusion: SARS-CoV-2 infection may affect left ventricular deformation in 30% of young adult patients despite an asymptomatic or only mildly symptomatic acute illness. Speckle-tracking echocardiography could help early identification of patients with subclinical cardiac involvement, with potential repercussions on risk stratification and management.
Keywords: COVID-19; SARS-CoV-2; myocardial strain; speckle tracking echocardiography.