Department of Cardiology, Herlev & Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Eur J Heart Fail. 2021 Nov;23(11):1903-1912. doi: 10.1002/ejhf.2347. Epub 2021 Oct 17.
The degree of cardiovascular sequelae following COVID-19 remains unknown. The aim of this study was to investigate whether cardiac function recovers following COVID-19.
A consecutive sample of patients hospitalized with COVID-19 was prospectively included in this longitudinal study. All patients underwent an echocardiographic examination during hospitalization and 2 months later. All participants were successfully matched 1:1 with COVID-19-free controls by age and sex. A total of 91 patients were included (mean age 63 ± 12 years, 59% male). A median of 77 days (interquartile range: 72-92) passed between the two examinations. Right ventricular (RV) function improved following resolution of COVID-19: tricuspid annular plane systolic excursion (TAPSE) (2.28 ± 0.40 cm vs. 2.11 ± 0.38 cm, P < 0.001) and RV longitudinal strain (RVLS) (25.3 ± 5.5% vs. 19.9 ± 5.8%, P < 0.001). In contrast, left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) did not significantly improve (17.4 ± 2.9% vs. 17.6 ± 3.3%, P = 0.6). N-terminal pro-B-type natriuretic peptide decreased between the two examinations [177.6 (80.3-408.0) ng/L vs. 11.7 (5.7-24.0) ng/L, P < 0.001]. None of the participants had elevated troponins at follow-up compared to 18 (27.7%) during hospitalization. Recovered COVID-19 patients had significantly lower GLS (17.4 ± 2.9% vs. 18.8 ± 2.9%, P < 0.001 and adjusted P = 0.004), TAPSE (2.28 ± 0.40 cm vs. 2.67 ± 0.44 cm, P < 0.001 and adjusted P < 0.001), and RVLS (25.3 ± 5.5% vs. 26.6 ± 5.8%, P = 0.50 and adjusted P < 0.001) compared to matched controls.
Acute COVID-19 affected negatively RV function and cardiac biomarkers but recovered following resolution of COVID-19. In contrast, the observed reduced LV function during acute COVID-19 did not improve post-COVID-19. Compared to the matched controls, both LV and RV function remained impaired.
COVID-19 后心血管后遗症的程度尚不清楚。本研究的目的是探讨 COVID-19 后心脏功能是否恢复。
连续纳入因 COVID-19 住院的患者进行这项前瞻性的纵向研究。所有患者在住院期间和 2 个月后均进行超声心动图检查。所有患者均成功地按年龄和性别与 COVID-19 无后遗症的对照组进行了 1:1 匹配。共纳入 91 例患者（平均年龄 63 ± 12 岁，59%为男性）。两次检查之间平均间隔 77 天（四分位距：72-92 天）。COVID-19 缓解后右心室（RV）功能改善：三尖瓣环平面收缩期位移（TAPSE）（2.28 ± 0.40 cm 比 2.11 ± 0.38 cm，P < 0.001）和 RV 纵向应变（RVLS）（25.3 ± 5.5%比 19.9 ± 5.8%，P < 0.001）。相比之下，左心室（LV）收缩功能评估的整体纵向应变（GLS）无显著改善（17.4 ± 2.9%比 17.6 ± 3.3%，P = 0.6）。两次检查之间，N 端脑利钠肽前体（NT-proBNP）降低[177.6（80.3-408.0）ng/L 比 11.7（5.7-24.0）ng/L，P < 0.001]。与住院期间相比，随访时无一例患者肌钙蛋白升高（18 例[27.7%]）。康复的 COVID-19 患者的 GLS 明显降低（17.4 ± 2.9%比 18.8 ± 2.9%，P < 0.001 和调整后的 P = 0.004），TAPSE（2.28 ± 0.40 cm 比 2.67 ± 0.44 cm，P < 0.001 和调整后的 P < 0.001）和 RVLS（25.3 ± 5.5%比 26.6 ± 5.8%，P = 0.50 和调整后的 P < 0.001）与匹配的对照组相比。
急性 COVID-19 对 RV 功能和心脏生物标志物有负面影响，但 COVID-19 缓解后即可恢复。相比之下，急性 COVID-19 期间观察到的 LV 功能降低在 COVID-19 后并未改善。与匹配的对照组相比，LV 和 RV 功能仍受损。
