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新冠肺炎后近期康复的低危门诊患者的左心室整体纵向应变。

Left ventricular global longitudinal strain in low cardiac risk outpatients who recently recovered from coronavirus disease 2019.

机构信息

Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Vatan St. Ortahisar, Trabzon, 61000, Turkey.

出版信息

Int J Cardiovasc Imaging. 2021 Oct;37(10):2979-2989. doi: 10.1007/s10554-021-02376-z. Epub 2021 Aug 13.

Abstract

The cardiac sequelae of coronavirus disease 2019 (COVID-19), a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.

摘要

新型冠状病毒病 2019(COVID-19)的心脏后遗症仍然不确定,尤其是在无症状、低心脏风险的门诊人群中。本研究旨在评估最近从 COVID-19 中康复的无症状、低心脏风险的门诊人群,使用二维左心室-整体纵向应变(LV-GLS)来检测亚临床心肌损伤。在 305 名 COVID-19 阳性患者中,确定 70 名无症状门诊患者为研究组,70 名年龄和性别匹配的健康成年人作为对照组。使用飞利浦 IE33 系统进行超声心动图检查,使用商业可得的 QLAB 9 软件(心脏运动定量;飞利浦医疗系统)测量 LV-GLS。LV-GLS 的绝对值≤18 被认为是 LV-GLS 受损。COVID-19 组的 LV-GLS 绝对值明显低于健康对照组(19.17±2.65 与 20.07±2.19,p=0.03)。使用 Pearson 相关检验检测从 COVID-19 中康复与 LV-GLS 受损(≤18)之间的相关性(p=0.02)。多变量逻辑回归分析发现,从 COVID-19 中康复是检测 LV-GLS 受损(≤18)的预测因子(优势比,0.133(0.038-0.461);95%CI,p=0.001)。本研究表明,即使在无症状、低心脏风险、在家隔离康复的患者人群中,COVID-19 也可能导致 LV-GLS 检测到亚临床左心室功能障碍。研究结果表明,这些患者的长期心血管随访可能比想象的更为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14de/8360821/e8d687efa367/10554_2021_2376_Fig1_HTML.jpg

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