TITLE:
Comprehensive Left Ventricular Mechanics Analysis by Speckle Tracking Echocardiography in COVID-19
AUTHORS:
Francisco J. González-Ruiz, Emmanuel A. Lazcano-Díaz, Zuilma Y. Vásquez-Ortiz, Fernanda Bernal-Ceballos, Rodrigo Gopar-Nieto, Consuelo Orihuela-Sandoval, José P. Hernández-Reyes, Edgar García-Cruz, Eduardo Bucio-Reta, Ángel Ramos-Enríquez, Luis A. Cota-Apodaca, Luis Efren-Santos, Blanca Estela Broca-García, Daniel Manzur-Sandoval, Efrén Melano-Carranza, Fernandez de la Reguera Guillermo, Gustavo Rojas-Velasco, Francisco Baranda-Tovar
KEYWORDS:
COVID-19, Speckle Tracking Echocardiography, Myocarditis, Cardiomyopa-thy, Cardiac Mechanics, Strain, Myocardial Damage, Deformation Imaging, Myocardial Strain
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.11 No.2,
February
19,
2021
ABSTRACT: Background: Cardiac involvement and the consequences of inflammation induced by SARS-CoV2 infection could have catastrophic long-term consequences. Left ventricular mechanics could identify a specific pattern of myocardial fiber damage in patients infected with COVID-19. To our knowledge there are no publications referring to the global description of ventricular mechanics in patients with COVID-19. Objective: To describe left ventricular mechanics in hospitalized patients with COVID-19. Methods: In this cross-sectional study, we included 40 hospitalized patients with confirmed diagnostic of COVID-19, from April 11, 2020, to September 6, 2020. Demographic and laboratory data, clinical and echocardiographic characteristics were collected, as well as events during hospitalization. Left ventricular deformation was analyzed and reported. Results: Subclinical dysfunction was observed in 82.5% (left ventricular longitudinal strain [LVGLS] -17.05% and global circumferential strain [GCS] -18.6%) of the patients, likewise, the mean twist and apical rotation were preserved, and even increased as part of the compensating mechanism to maintain the ejection fraction. Conclusion: In patients hospitalized with COVID-19, despite having a normal left ventricular ejection fraction, subclinical myocardial damage was found, manifested by a decrease in Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS). This behavior is similar to that of cardiomyopathies in the early stage of the disease, and given the pathophysiological mechanisms involved in the disease, its long-term consequences should be monitored and evaluated.