Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Vatan St. Ortahisar, Trabzon, 61000, Turkey.
Int J Cardiovasc Imaging. 2021 Oct;37(10):2979-2989. doi: 10.1007/s10554-021-02376-z. Epub 2021 Aug 13.
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.
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。