Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei, Taiwan.
Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan.
Sci Rep. 2024 May 13;14(1):10849. doi: 10.1038/s41598-024-61641-y.
Cardiac discomfort has been reported periodically in COVID-19-vaccinated individuals. Thus, this study aimed to evaluate the role of myocardial strains in the early assessment of the clinical presentations after COVID-19 vaccination. Totally, 121 subjects who received at least one dose of vaccine within 6 weeks underwent laboratory tests, electrocardiogram (ECG), and echocardiogram. Two-dimensional speckle tracking echocardiography (2D-STE) was implemented to analyze changes in the left ventricular myocardium. After vaccination, 66 individuals (55.4 ± 17.4 years) developed cardiac discomforts, such as chest tightness, palpitations, dyspnea, and chest pain. The ECG readings exhibited both premature ventricular contractions and premature atrial contractions (n = 24, 36.4%), while none of the individuals in the control group manifested signs of cardiac arrhythmia. All had normal serum levels of creatine phosphokinase, creatine kinase myocardial band, troponin, N-terminal pro b-type natriuretic peptide, platelets, and D-dimer. Left ventricular ejection fraction in the symptomatic group (71.41% ± 7.12%) and the control group (72.18% ± 5.11%) (p = 0.492) were normal. Use of 2D-STE presented global longitudinal strain (GLS) and global circumferential strain (GCS) was reduced in the symptomatic group (17.86% ± 3.22% and 18.37% ± 5.22%) compared to the control group (19.54% ± 2.18% and 20.73% ± 4.09%) (p = 0.001 and p = 0.028). COVID-19 vaccine-related cardiac adverse effects can be assessed early by 2D-STE. The prognostic implications of GLS and GCS enable the evaluation of subtle changes in myocardial function after vaccination.
接种 COVID-19 疫苗后,有报道称部分人群会出现周期性的心脏不适。因此,本研究旨在评估心肌应变在评估 COVID-19 疫苗接种后临床症状中的早期作用。共有 121 名在 6 周内至少接种过一剂疫苗的受试者接受了实验室检查、心电图(ECG)和超声心动图检查。采用二维斑点追踪超声心动图(2D-STE)分析左心室心肌变化。接种疫苗后,66 人(55.4±17.4 岁)出现心脏不适,如胸闷、心悸、呼吸困难和胸痛。心电图显示频发室性期前收缩和房性期前收缩(n=24,36.4%),而对照组均无心律失常迹象。所有患者的肌酸磷酸激酶、肌酸激酶同工酶、肌钙蛋白、N 末端 pro-B 型利钠肽、血小板和 D-二聚体水平均正常。症状组(71.41%±7.12%)和对照组(72.18%±5.11%)的左心室射血分数(p=0.492)正常。2D-STE 显示,症状组的整体纵向应变(GLS)和整体圆周应变(GCS)分别为 17.86%±3.22%和 18.37%±5.22%,低于对照组的 19.54%±2.18%和 20.73%±4.09%(p=0.001 和 p=0.028)。2D-STE 可早期评估与 COVID-19 疫苗相关的心脏不良事件。GLS 和 GCS 的预后意义可评估接种疫苗后心肌功能的细微变化。