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. 2021 Jul;37(7):2227-2233.
doi: 10.1007/s10554-021-02211-5. Epub 2021 Mar 16.

Evaluation of left ventricular global functions with speckle tracking echocardiography in patients recovered from COVID-19

Savaş Özer  1 , Lütfullah Candan  2 , Ali Gökhan Özyıldız  3 , Oğuzhan Ekrem Turan  2
Affiliations

Evaluation of left ventricular global functions with speckle tracking echocardiography in patients recovered from COVID-19

Savaş Özer et al. Int J Cardiovasc Imaging. 2021 Jul.

Abstract

Highly sensitive troponin (hs-TnI) levels are frequently elevated in COVID-19 patients and are associated with increased cardiovascular mortality during hospitalization. However, no data exists on cardiac involvement in patients recovered from COVID-19 infection. We aimed to evaluate by global longitudinal strain (LV-GLS) whether there is subclinical myocardial deformation after COVID-19 infection. Two-dimensional speckle tracking echocardiography (2D-STE) was performed within 29.5 ± 4.5 days after COVID-19 treatment. The standard GLS limit was identified at < -18%. The patients were divided into two groups according to their hs-TnI levels during hospitalization as with (> 11.6 ng/dl) and without (< 11.6 ng/dl) myocardial injury. Patients' (n = 74) mean age was 59.9 years, and women were in the majority (60.8%). Of the patients, 43.2% of them were hypertensive, and 10.9% were diabetic. Abnormal LV-GLS values (> -18) were measured in 28 patients (37.8%). While 16 (57.1%) of these patients were in the group with myocardial injury, 12 (26.1%) of them were in the group without myocardial injury (p = 0.014). D-dimer, C reactive protein, white blood cell levels were higher in the group with myocardial injury (All p values < 0.05). Electrocardiographically, 9 (12.2%) patients had T wave inversion, while two patients had a bundle branch block. Subclinical left ventricular dysfunction was observed in approximately one-third of the patients at the one-month follow-up after COVID-19 infection. This rate was higher in those who develop myocardial injury during hospitalization. This result suggests that patients recovered from COVID-19 infection should be evaluated and followed in terms of cardiac involvement.

Keywords: COVID-19 infection; Coronavirus; Left ventricular global longitudinal strain; Transthoracic echocardiography.

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Conflict of interest statement

All the authors declared that they have no confict of interest.

Figures

Fig. 1
Fig. 1
Study flow chart, Post COVID-19 patients
Fig. 2
Fig. 2
An example of global longitudinal strain speckle tracking apical four chamber view of myocardial injury patient
Fig. 3
Fig. 3
Scatter plot graphic revealed the relation between troponin and LV-GLS values
See this image and copyright information in PMC

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