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应用斑点追踪超声心动图评估 COVID-19 患者左心室整体功能。

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

机构信息

Trabzon Kanuni Training and Research Hospital Cardiology Clinic, Trabzon, Turkey.

Faculty of Medicine Department of Cardiology, Karadeniz Technical University, Trabzon, Turkey.

出版信息

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

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.

摘要

新型冠状病毒(COVID-19)患者的高敏肌钙蛋白(hs-TnI)水平经常升高,并与住院期间心血管死亡率增加相关。然而,目前尚无关于 COVID-19 感染康复患者心脏受累的相关数据。我们旨在通过整体纵向应变(LV-GLS)评估 COVID-19 感染后是否存在亚临床心肌变形。在 COVID-19 治疗后 29.5±4.5 天内进行二维斑点追踪超声心动图(2D-STE)检查。标准 GLS 限制定义为<−18%。根据住院期间 hs-TnI 水平将患者分为两组:伴有(>11.6ng/dl)和不伴有(<11.6ng/dl)心肌损伤。患者(n=74)的平均年龄为 59.9 岁,女性占多数(60.8%)。其中 43.2%的患者患有高血压,10.9%的患者患有糖尿病。28 名患者(37.8%)的 LV-GLS 值异常(>−18)。这些患者中有 16 名(57.1%)在伴有心肌损伤的组中,12 名(26.1%)在不伴有心肌损伤的组中(p=0.014)。伴有心肌损伤组的 D-二聚体、C 反应蛋白和白细胞水平较高(所有 p 值均<0.05)。心电图检查中,9 名(12.2%)患者有 T 波倒置,2 名患者有束支传导阻滞。在 COVID-19 感染后一个月的随访中,约三分之一的患者观察到亚临床左心室功能障碍。在住院期间发生心肌损伤的患者中,这种比率更高。该结果表明,COVID-19 感染康复的患者应评估和随访心脏受累情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7775/7961169/35c213cd20c2/10554_2021_2211_Fig1_HTML.jpg

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