Division of Echocardiography, Cardioimagem Clínica Cardiológica, SHIS QI7 conjunto 1 casa 11, Brasilia, DF, 71615-210, Brazil.
J Echocardiogr. 2022 Mar;20(1):51-56. doi: 10.1007/s12574-021-00555-4. Epub 2021 Oct 14.
Coronavirus disease-19 (COVID-19) has been associated with subclinical myocardial dysfunction during its acute phase and a recurring pattern of reduced basal left ventricular longitudinal strain on speckle-tracking echocardiography (STE) in hospitalized patients. But a question still remains unanswered: speckle-tracking echocardiography might also be suitable to detect residual myocardial involvement after acute stage of COVID-19?
We studied 100 patients recovered from COVID-19 with STE to evaluate global (GLS) and segmentar longitudinal strain (LS) and compared with a control group of 100 healthy individuals. STE was performed at a median of 130.35 ± 76.06 days after COVID-19 diagnostic. Demographic and echocardiographic parameters are similar in both groups. Left ventricular ejection faction (LVEF) and GLS were normal in COVID-19 patients (66.20 ± 1.98% and - 19.51 ± 2.87%, respectively). A reduction in mean LS for the basal segments was found in COVID-19 (16.48 ± 5.41%) when compared to control group (19.09 ± 4.31%) (p < 0.001).
The present study suggests that COVID-19-induced cardiac involvement could persist after recovery of the disease and may be detected by deformation abnormalities using STE. COVID-19-induced myocardial involvement often shows specific LV deformation patterns due to pronounced edema and/or myocardial damage in basal LV segments.
新型冠状病毒疾病-19（COVID-19）在其急性期与亚临床心肌功能障碍相关，并在住院患者的斑点追踪超声心动图（STE）上反复出现基底左心室纵向应变降低的模式。但是，仍然存在一个悬而未决的问题：斑点追踪超声心动图是否也适合检测 COVID-19 急性阶段后的残留心肌受累？
我们研究了 100 名从 COVID-19 中康复的患者，使用 STE 评估整体（GLS）和节段性纵向应变（LS），并与 100 名健康对照组进行比较。STE 在 COVID-19 诊断后中位数为 130.35±76.06 天进行。两组的人口统计学和超声心动图参数相似。COVID-19 患者的左心室射血分数（LVEF）和 GLS 正常（分别为 66.20±1.98%和-19.51±2.87%）。与对照组（19.09±4.31%）相比，COVID-19 患者的基底段平均 LS 降低（16.48±5.41%）（p<0.001）。
本研究表明，COVID-19 引起的心脏受累可能在疾病康复后持续存在，并且可能通过 STE 检测到变形异常。COVID-19 引起的心肌受累通常由于基底 LV 段明显的水肿和/或心肌损伤而显示出特定的 LV 变形模式。
