Harada Mikiko, Engl Tobias, Köble Katharina, Mühlbauer Frauke, Baumgartner Lisa, Goeder Daniel, Dettenhofer Maximilian, Oberhoffer-Fritz Renate
Institute of Preventive Pediatrics, Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
CJC Pediatr Congenit Heart Dis. 2024 Aug 9;3(5):203-213. doi: 10.1016/j.cjcpc.2024.08.001. eCollection 2024 Oct.
Cardiovascular impairment has been observed in adults with coronavirus disease 2019 (COVID-19), even in those with mild symptoms. Physical activity can reveal subtle cardiovascular dysfunction that is not apparent at rest. However, there are limited data on cardiovascular function in children and adolescents after the COVID-19 infection. This study aimed to assess cardiovascular function in paediatric and adolescent populations with a history of COVID-19 infection and controls by conducting 2-dimensional transthoracic echocardiography at rest (TTE-R) and exercise stress echocardiography (ESE).
We conducted TTE-R, including speckle tracking strain analysis of both ventricles, on 100 individuals (median age 12.3 years, 82% male), divided into 2 groups: 73 adolescents with COVID-19 infection and 27 controls. A subset of male participants (40 cases, 15 controls) underwent ESE combined with a cardiopulmonary exercise test (CPET-ESE) to examine the relationship between cardiovascular parameters and contractile reserve. Myocardial contractile reserve was evaluated by measuring the maximum increase in strain values during exercise.
At rest, no signs of myocardial injury or inflammation were observed. Right and left ventricular contractility in the infected group were clinically equivalent to those in the controls. During CPET-ESE, peak oxygen consumption was similar between the infected and control groups. Furthermore, contractile reserve under exercise was similar in both groups.
We found no significant differences in left ventricular systolic and diastolic function and right ventricle systolic function evaluated by TTE-R between participants with a history of mild COVID-19 infection and controls. ESE provided insights for post-COVID-19 young people resuming activities and sports.
在2019冠状病毒病（COVID-19）成年患者中已观察到心血管损伤，即使是那些症状轻微的患者。体育活动可揭示静息时不明显的细微心血管功能障碍。然而，关于COVID-19感染后儿童和青少年心血管功能的数据有限。本研究旨在通过静息二维经胸超声心动图（TTE-R）和运动负荷超声心动图（ESE）评估有COVID-19感染病史的儿童和青少年人群以及对照组的心血管功能。
我们对100名个体（中位年龄12.3岁，82%为男性）进行了TTE-R，包括对两个心室的斑点追踪应变分析，将其分为两组：73名感染COVID-19的青少年和27名对照组。一部分男性参与者（40例，15名对照）接受了ESE联合心肺运动试验（CPET-ESE），以检查心血管参数与收缩储备之间的关系。通过测量运动期间应变值的最大增加来评估心肌收缩储备。
静息时，未观察到心肌损伤或炎症迹象。感染组的右心室和左心室收缩力在临床上与对照组相当。在CPET-ESE期间，感染组和对照组的峰值耗氧量相似。此外，两组运动时的收缩储备相似。
我们发现，在有轻度COVID-19感染病史的参与者和对照组之间，通过TTE-R评估的左心室收缩和舒张功能以及右心室收缩功能没有显著差异。ESE为COVID-19康复后的年轻人恢复活动和运动提供了参考依据。
