1. Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography
- Author
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Li, Rui, Wang, Hong, Ma, Fei, Cui, Guang-lin, Peng, Li-yuan, Li, Chen-ze, Zeng, He-song, Marian, Ali J., and Wang, Dao-wen
- Abstract
COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus. Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury, but imaging evidence is lacking. In the study we detected and evaluated the severity of myocardial dysfunction in COVID-19 patient population using two-dimensional speckle-tracking echocardiography (2-D STE). A total of 218 consecutive patients with confirmed diagnosis of COVID-19 who had no underlying cardiovascular diseases were enrolled and underwent transthoracic echocardiography. This study cohort included 52 (23.8%) critically ill and 166 noncritically ill patients. Global longitudinal strains (GLSs) and layer-specific longitudinal strains (LSLSs) were obtained using 2-D STE. Changes in GLS were correlated with the clinical parameters. We showed that GLS was reduced (<−21.0%) in about 83% of the patients. GLS reduction was more common in critically sick patients (98% vs. 78.3%, P< 0.001), and the mean GLS was significantly lower in the critically sick patients than those noncritical (−13.7% ± 3.4% vs. −17.4% ± 3.2%, P< 0.001). The alteration of GLS was more prominent in the subepicardium than in the subendocardium (P< 0.001). GLS was correlated to mean serum pulse oxygen saturation (SpO2, RR = 0.42, P< 0.0001), high-sensitive C-reactive protein (hsCRP, R= −0.20, P= 0.006) and inflammatory cytokines, particularly IL-6 (R= −0.21, P= 0.003). In conclusions, our results demonstrate that myocardial dysfunction is common in COVID-19 patients, particularly those who are critically sick. Changes in indices of myocardial strain were associated with indices of inflammatory markers and hypoxia, suggesting partly secondary nature of myocardial dysfunction.
- Published
- 2021
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