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Cardiovascular outcome 6 months after severe coronavirus disease 2019 infection.

Authors :
Raafs AG
Ghossein MA
Brandt Y
Henkens MTHM
Kooi ME
Vernooy K
Spaanderman MEA
Gerretsen S
van Santen S
Driessen RGH
Knackstedt C
van der Horst ICC
van Bussel BCT
Heymans SRB
Ghossein-Doha C
Source :
Journal of hypertension [J Hypertens] 2022 Jul 01; Vol. 40 (7), pp. 1278-1287. Date of Electronic Publication: 2022 Feb 25.
Publication Year :
2022

Abstract

Objectives: In coronavirus disease 2019 (COVID-19), cardiovascular risk factors and myocardial injury relate to increased mortality. We evaluated the extent of cardiac sequelae 6 months after hospital discharge in patients surviving ICU hospitalization for COVID-19.<br />Methods: All survivors of Maastricht-ICU were invited for comprehensive cardiovascular evaluation 6 months after discharge from ICU. Cardiac screening included an electrocardiogram, cardiac biomarkers, echocardiography, cardiac magnetic resonance (CMR) and, wherever indicated, cardiac computed tomography or coronary angiogram.<br />Results: Out of 52 survivors, 81% ( n  = 42) participated to the cardiovascular follow-up [median follow-up of 6 months, interquartile range (IQR) 6.1-6.7]. Eight patients (19%) had newly diagnosed coronary artery disease (CAD), of which two required a percutaneous intervention. Echocardiographic global longitudinal strain (GLS) was abnormal in 24% and CMR-derived GLS was abnormal in 12%, despite normal left ventricular ejection fraction in all. None of the patients showed elevated T 1 relaxation times and five patients (14%) had an elevated T 2 relaxation time. Late gadolinium enhancement (LGE) reflecting regional myocardial fibrosis was increased in eight patients (21%), of which three had myocarditis and three had pericarditis.<br />Conclusion: Cardiovascular follow-up at 6 months after ICU-admission for severe COVID-19 revealed that one out of five invasively mechanically ventilated survivors had CAD, a quarter had subclinical left ventricular dysfunction defined as reduced echocardiographic GLS, and 42% of the patients had CMR abnormalities (reduced LVEF, reduced GLS, LGE presence, and elevated T 2 ). On the basis of these findings, long-term cardiovascular follow-up is strongly recommended in all post-IC COVID-19 patients.<br />Clinical Trial Registration: Trial Register number [NL8613]) https://www.trialregister.nl/trial/8613Video abstract:http://links.lww.com/HJH/B899 .<br /> (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Details

Language :
English
ISSN :
1473-5598
Volume :
40
Issue :
7
Database :
MEDLINE
Journal :
Journal of hypertension
Publication Type :
Academic Journal
Accession number :
35221322
Full Text :
https://doi.org/10.1097/HJH.0000000000003110