Tryfou Elsi S, Kostakou Peggy M, Chasikidis Christos G, Kostopoulos Vassilios S, Serafetinidis Ioannis I, Ferdianaki Efterpi K, Mihas Constantinos, Olympios Christoforos D, Kouris Nikos T
Cardiology Department, General Hospital of Korinthos, Athinon 53, 20100, Corinth, Greece.
Cardiology Department, General Hospital of Elefsina "Thriassio", Athens, Greece.
Int J Cardiovasc Imaging. 2022 May;38(5):995-1003. doi: 10.1007/s10554-021-02498-4. Epub 2021 Dec 23.
Although severe acute respiratory syndrome coronavirus 2 causes respiratory disease, it may also lead to cardiovascular involvement with unknown long-term consequences. The aim of our study was to evaluate prospectively cardiac involvement in patients after the recovery from Covid-19, using two-dimensional speckle tracking echocardiography. 100 Covid-19 recovered patients with preserved left ventricular ejection fraction, were included, divided based upon clinical manifestation into two groups, those who were treated ambulant and those who were hospitalized. All patients underwent echocardiographic evaluation after their recovery. Although overall LV systolic function expressed by EF was normal, left ventricular global longitudinal strain (LVGLS) was significantly lower in Covid-19 recovered patients (33.28 ± 9.4 days after diagnosis) compared to controls (- 18.47 ± - 2.4 vs. - 21.07 ± - 1.76% respectively, p < 0.0001). Εspecially the lateral wall longitudinal strain (LATLS) and posterior wall longitudinal strain (POSTLS) were significantly reduced in all patients compared to controls (- 17.77 ± - 3.48 vs. - 20.97 ± - 2.86%, p < 0.0001 and - 19.52 ± - 5.3 vs. - 22.23 ± - 2.65%, p = 0.01). right ventricular global longitudinal strain (RVGLS) was significantly diminished only in the hospitalized group of Covid-19 recovered patients, compared to controls (- 18.17 ± - 3.32 vs. - 26.03 ± - 4.55% respectively, p < 0.0001). LVGLS is affected in almost all individuals after Covid-19 infection independently of the infection severity, with LATLS being the most sensitive marker of LV impairment and with POSTLS to follow. RV shows impaired GLS in severely ill patients highlighting RVGLS as a helpful tool of prognosis. Recovered patients from Covid-19 infection have to be monitored for a long time, since the term "long Covid disease" might also include the cardiac function.
尽管严重急性呼吸综合征冠状病毒2会引发呼吸系统疾病，但它也可能导致心血管受累，其长期后果尚不清楚。我们研究的目的是使用二维斑点追踪超声心动图对新冠病毒病康复后的患者心脏受累情况进行前瞻性评估。纳入了100例左心室射血分数保留的新冠病毒病康复患者，根据临床表现分为两组，即门诊治疗组和住院治疗组。所有患者康复后均接受了超声心动图评估。尽管用射血分数表示的左心室整体收缩功能正常，但新冠病毒病康复患者（诊断后33.28±9.4天）的左心室整体纵向应变（LVGLS）明显低于对照组（分别为-18.47±-2.4与-21.07±-1.76%，p<0.0）。尤其是所有患者的侧壁纵向应变（LATLS）和后壁纵向应变（POSTLS）与对照组相比均明显降低（分别为-17.77±-3.48与-20.97±-2.86%，p<0.0；以及-19.52±-5.3与-22.23±-2.65%，p=0.01）。与对照组相比，仅在新冠病毒病康复患者的住院组中右心室整体纵向应变（RVGLS）明显降低（分别为-18.17±-3.32与-26.03±-4.55%，p<0.0）。新冠病毒病感染后几乎所有个体的LVGLS均受影响，与感染严重程度无关，其中LATLS是左心室损伤最敏感的标志物，其次是POSTLS。右心室在重症患者中显示出整体纵向应变受损，突出了RVGLS作为一种有用的预后工具。新冠病毒病感染康复患者必须长期监测，因为“长新冠疾病”一词可能也包括心脏功能。
