Shchendrygina Anastasia, Ka Mame Madjiguène, Rodriguez Carlos, Alsoufi Safaa, Hoffmann Jedrzej, Kumar Parveen, Carerj Maria Ludovica, Vanchin Byambasuren, Holm Niels, Karyou Argyro, Ganbat Mijidsuren, Nagel Eike, Puntmann Valentina O
Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt, Frankfurt am Main, Germany.
Sci Rep. 2025 Jan 30;15(1):3772. doi: 10.1038/s41598-025-85221-w.
The aim of this study was to evaluate the subclinical patterns and evolution of cardiac abnormalities via transthoracic echocardiography (TTE) in patients with mild initial COVID-19 illness. A total of 343 infected individuals (163 males; age 44 (interquartile range, IQR 35-52) years) years) underwent serial TTE assessments at a median of 109 (interquartile range (IQR), 77-177) and 327 (276-379) days after infection. Compared with those of non-COVID-19-infected controls (n = 94, male n = 49), baseline systolic (LVEF, TAPSE) and diastolic function (e', a', E/e') were significantly different in infected participants (p < 0.05 for all). Compared with baseline assessments, there was a reduction in global longitudinal strain (GLS) and an increase in the E wave, E/A ratio and E/e' at follow-up. At baseline, symptomatic participants had a lower LVEF and TAPSE and increased IVRT, e' and E/e'. At follow-up, symptomatic patients had a lower LV end-diastolic diameter (LVEDd). Symptoms were independently associated with E/e' at baseline (OR (95% CI) 1.45 (1.12-1.87), p = 0.005). Symptoms at follow-up were associated with LVEDd, measured either at baseline (OR: 0.91 (0.86, 0.96), p < 0.001) or follow-up (OR (95% CI) 0.91 (0.86-0.96), p < 0.001). There were significant associations for GLS and troponin and E/e' with CRP and NTproBNP at baseline. In the present cohort of COVID-19-infected individuals with mild initial illness, echocardiographic measurements revealed significant yet subclinical differences in systolic and diastolic function compared with controls, as well as between individuals with cardiac symptoms and those without. All the measured differences were small in magnitude and thus unlikely to be detectable clinically at the individual level.
本研究的目的是通过经胸超声心动图（TTE）评估轻度初始COVID-19疾病患者心脏异常的亚临床模式及演变情况。共有343名感染者（163名男性；年龄44岁（四分位间距，IQR 35 - 52岁））在感染后中位数为109天（四分位间距（IQR），77 - 177天）和327天（276 - 379天）时接受了系列TTE评估。与未感染COVID-19的对照组（n = 94，男性n = 49）相比，感染参与者的基线收缩功能（左心室射血分数、三尖瓣环平面收缩期位移）和舒张功能（e'、a'、E/e'）存在显著差异（所有p值均<0.05）。与基线评估相比，随访时整体纵向应变（GLS）降低，E波、E/A比值和E/e'升高。在基线时，有症状的参与者左心室射血分数和三尖瓣环平面收缩期位移较低，等容舒张时间、e'和E/e'升高。随访时，有症状的患者左心室舒张末期内径（LVEDd）较低。症状在基线时与E/e'独立相关（比值比（95%置信区间）1.45（1.12 - 1.87），p = 0.005）。随访时的症状与LVEDd相关，LVEDd可在基线时测量（比值比：0.91（0.86，0.96），p < 0.001）或在随访时测量（比值比（95%置信区间）0.91（0.86 - 0.96），p < 0.001）。在基线时，GLS、肌钙蛋白以及E/e'与C反应蛋白和N末端脑钠肽前体之间存在显著关联。在本队列初始病情较轻的COVID-19感染者中，超声心动图测量显示，与对照组相比，以及有心脏症状者与无心脏症状者之间，收缩和舒张功能存在显著但亚临床的差异。所有测量到的差异幅度都很小，因此在个体水平上临床上不太可能检测到。
