Background: Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography. Methods: This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed. Results: The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1±.3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure. Conclusions: In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.

Subclinical myocardial dysfunction in patients recovered from COVID-19 / Italia, L.; Ingallina, G.; Napolano, A.; Boccellino, A.; Belli, M.; Cannata, F.; Rolando, M.; Ancona, F.; Melillo, F.; Stella, S.; Ripa, M.; Scarpellini, P.; Tresoldi, M.; Ortalda, A.; Righetti, B.; De Cobelli, F.; Esposito, A.; Ciceri, F.; Castagna, A.; Rovere, P. Q.; Fragasso, G.; Agricola, E.. - In: ECHOCARDIOGRAPHY. - ISSN 0742-2822. - (2021). [Epub ahead of print] [10.1111/echo.15215]

Subclinical myocardial dysfunction in patients recovered from COVID-19

Napolano A.;Boccellino A.;Ripa M.;Ortalda A.;Righetti B.;De Cobelli F.;Esposito A.;Ciceri F.;Castagna A.;Rovere P. Q.;Agricola E.
2021-01-01

Abstract

Background: Myocardial injury (MI) can be detected during the acute phase of Coronavirus disease 19 (COVID-19) and is associated with a dismal prognosis. Recent imaging studies described the persistence of cardiac abnormalities after the recovery. The aim of the study was to investigate the spectrum of cardiac abnormalities at mid-term follow-up in patients recovered from COVID-19 using clinical assessment, laboratory tests, and imaging evaluation with comprehensive echocardiography. Methods: This is an observational, cross-sectional study assessing an unselected cohort of consecutive patients recovered from COVID-19. MI was defined by elevated plasma levels of high sensitive troponin T (hsTnT). At the follow-up, a complete examination including echocardiography was performed. Results: The 123 patients included were divided into two groups according to the presence of MI during hospitalization: group A (without MI) and group B (with MI). After a median of 85 days, group B patients were more frequently symptomatic for dyspnea and had significantly higher values of hsTnT and N-Terminal prohormone of Brain Natriuretic Peptide (NT-proBNP), compared to Group A. No differences between the two groups in left nor right ventricle dimension and ejection fraction were found. However, in group B a significant reduction of mean left ventricle global longitudinal strain was observed (-15.7±.7 vs -18.1±.3 in group A, p < 0.001), together with higher frequency of impaired diastolic function and higher values of pulmonary pressure. Conclusions: In patients recovered from COVID-19, echocardiography with speckle-tracking analysis may be an useful imaging tool to identify subclinical myocardial dysfunction and potentially guide management strategies.
2021
COVID-19
echocardiography
heart failure
myocarditis
strain
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/120894
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