Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of General Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan.
PLoS One. 2019 Aug 23;14(8):e0221628. doi: 10.1371/journal.pone.0221628. eCollection 2019.
Influenza virus infection (IVI) was reported to be associated with minor cardiac changes, mostly those detected on electrocardiogram with and without elevated blood markers of myocardial injury; however, the characteristics of myocardial involvement in association with IVI are poorly understood. This study used echocardiographic tissue imaging (tissue Doppler, strain, and strain rate) to evaluate changes in left atrial (LA) and left ventricular (LV) myocardial function after IVI.
We examined 20 adult individuals (mean age, 43 years) at 2 and 4 weeks after diagnosis of IVI. For myocardial functional variables, we obtained LV global longitudinal strain (GLS), LV early diastolic strain rate (e'sr), LA strain, and LA stiffness (E/e'/LA strain), in addition to data on tissue Doppler (s', e', and a') and myocardial performance index. Blood markers of myocardial injury were also examined. During follow-up, there were no significant changes in global chamber function such as LV ejection fraction, E/e', and LA volume. However, significant changes in myocardial function were observed, namely, in s' (8.0 ± 1.6 cm/s to 9.3 ± 1.5 cm/s; p = 0.01), e' (10.2 ± 2.8 cm/s to 11.4 ± 3.0 cm/s; p < 0.001), e'sr (1.43 ± 0.44 1/s to 1.59 ± 0.43 1/s; p = 0.005), and LA strain (35 ± 8% to 40 ± 12%; p = 0.025), and the myocardial performance index (0.52 ± 0.20 to 0.38 ± 0.09; p = 0.009), but not in a', LA stiffness, or GLS. Cardiac troponin T and creatinine kinase isoenzyme MB were not elevated significantly at any examination.
Myocardial dysfunction during IVI recovery appeared to be transient particularly in the absence of myocardial injury. Echocardiographic tissue imaging may be useful to detect subclinical cardiac changes in association with IVI.
流感病毒感染（IVI）与心脏的轻微变化有关，这些变化主要通过心电图检测到，同时伴有心肌损伤的血液标志物升高；然而，IVI 相关的心肌受累的特征尚不清楚。本研究使用超声心动图组织成像（组织多普勒、应变和应变率）评估 IVI 后左心房（LA）和左心室（LV）心肌功能的变化。
我们在诊断 IVI 后 2 周和 4 周时检查了 20 名成年个体（平均年龄，43 岁）。对于心肌功能变量，我们获得了 LV 整体纵向应变（GLS）、LV 早期舒张应变率（e'sr）、LA 应变和 LA 僵硬度（E/e'/LA 应变），以及组织多普勒（s'、e'和 a'）和心肌性能指数的数据。还检查了心肌损伤的血液标志物。在随访期间，LV 射血分数、E/e'和 LA 容积等整体心室功能没有明显变化。然而，观察到心肌功能发生了显著变化，即 s'（8.0±1.6 cm/s 至 9.3±1.5 cm/s；p=0.01）、e'（10.2±2.8 cm/s 至 11.4±3.0 cm/s；p<0.001）、e'sr（1.43±0.44 1/s 至 1.59±0.43 1/s；p=0.005）和 LA 应变（35±8%至 40±12%；p=0.025）以及心肌性能指数（0.52±0.20 至 0.38±0.09；p=0.009），而 a'、LA 僵硬度或 GLS 没有明显变化。在任何检查中，心肌肌钙蛋白 T 和肌酸激酶同工酶 MB 均未显著升高。
IVI 恢复期间的心肌功能障碍似乎是短暂的，特别是在没有心肌损伤的情况下。超声心动图组织成像可能有助于检测与 IVI 相关的亚临床心脏变化。
