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Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and

Arief Wibowo1, Raymond Pranata1,2, Astri Astuti1

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat, 40161, Indonesia.

Journal of Intensive Care
|January 13, 2021
PubMed

Insights

Lower left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) indicate a higher risk of poor outcomes in COVID-19 patients. These echocardiographic measurements can serve as valuable prognostication tools.

Area of Science:

  • Cardiology
  • Echocardiography
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) poses significant risks, necessitating tools for patient prognostication.
  • Ventricular strain parameters, particularly left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS), are emerging echocardiographic markers.

Purpose of the Study:

  • To systematically review and meta-analyze the utility of ventricular longitudinal strain (VLS) as a prognostic indicator in COVID-19 patients.
  • To determine the association between LV-GLS and RV-LS with poor outcomes, including mortality and severe disease.

Main Methods:

  • Systematic literature searches were conducted in PubMed, Embase, and EuropePMC databases up to November 16, 2020.
  • Included studies utilized speckle tracking echocardiography to measure LV-GLS and RV-LS.
  • Poor outcome was defined as a composite of mortality and severe COVID-19.

Main Results:

  • Seven studies with 612 patients were included in the meta-analysis.
  • Lower LV-GLS was significantly associated with poor outcomes (SMD 1.15; p < 0.001), with each 1% decrease increasing poor outcome risk by 1.4x (OR 1.37; p = 0.002).
  • Lower RV-LS also correlated with poor outcomes (SMD 1.18; p < 0.001), where each 1% decrease elevated poor outcome risk by 1.3x (OR 1.25; p < 0.001).

Conclusions:

  • Reduced LV-GLS and RV-LS measurements are significantly associated with adverse outcomes in patients diagnosed with COVID-19.
  • These echocardiographic strain parameters demonstrate potential as valuable tools for prognostication in COVID-19 management.
Abstract

Keywords:
COVID-19EchocardiographyLongitudinal strainSARS-CoV-2Ventricle

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