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Observational Study
. 2021 Oct;38(10):1778-1786.
doi: 10.1111/echo.15215. Epub 2021 Oct 21.

Subclinical myocardial dysfunction in patients recovered from COVID-19

Leonardo Italia  1 , Giacomo Ingallina  1 , Antonio Napolano  1 , Antonio Boccellino  1 , Martina Belli  1 , Francesco Cannata  1 , Marco Rolando  1 , Francesco Ancona  1 , Francesco Melillo  1 , Stefano Stella  1 , Marco Ripa  2 , Paolo Scarpellini  2 , Moreno Tresoldi  3 , Alessandro Ortalda  4 , Beatrice Righetti  4 , Francesco De Cobelli  5   6 , Antonio Esposito  5   6 , Fabio Ciceri  5   7 , Antonella Castagna  2   5 , Patrizia Querini Rovere  5   8 , Gabriele Fragasso  9 , Eustachio Agricola  1   5
Affiliations
Observational Study

Subclinical myocardial dysfunction in patients recovered from COVID-19

Leonardo Italia et al. Echocardiography. 2021 Oct.

Abstract

Background: Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography.

Methods: This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed.

Results: The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1± .3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure.

Conclusions: In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.

Keywords: COVID-19; echocardiography; heart failure; myocarditis; strain.

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Figures

FIGURE 1
FIGURE 1
Study Flowchart
FIGURE 2
FIGURE 2
Main echocardiographic differences in patients recovered from COVID‐19 with and without myocardial injury during hospitalization
See this image and copyright information in PMC

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