Strain Echocardiography in Acute COVID-19 and Post-COVID Syndrome: More than Just a Snapshot

Abstract

Speckle-tracking echocardiography (STE) has become an established, widely available diagnostic method in the past few years, making its value clear in cases of COVID-19 and the further course of the disease, including post-COVID syndrome. Since the beginning of the pandemic, many studies have been published on the use of STE in this condition, enabling, on the one hand, a better understanding of myocardial involvement in COVID-19 and, on the other, a better identification of risk to patients, although some questions remain unanswered in regard to specific pathomechanisms, especially in post-COVID patients. This review takes a closer look at current findings and potential future developments by summarising the extant data on the use of STE, with a focus on left and right ventricular longitudinal strain.

Keywords: COVID-19; post-COVID; speckle-tracking echocardiography; strain.

Figure 1

Example of a patient with reduced left ventricular global longitudinal strain (GLS) of −12.1%. Apical 4-, 3- and 2-chamber view (A–C) with highlighted left ventricular myocardium. Bullseye plot (D) shows globally reduced longitudinal strain with accentuation basally septal and midventricular anterior/anterolateral.

Figure 2

Example of a young athlete who was examined after COVID-19 before returning to sport. Transthoracic 3D echocardiography revealed normal left ventricular (A) and right ventricular function (B).