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Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19

Maria-Luiza Luchian1, Andreea Motoc1, Stijn Lochy1

  • 1Department of Cardiology, (Centrum voor Hart-en Vaatziekten), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.

Diagnostics (Basel, Switzerland)
|January 21, 2022
PubMed

Insights

Long COVID patients frequently experience dyspnea due to subclinical cardiac dysfunction. Echocardiography revealed reduced myocardial performance in symptomatic individuals, indicating potential long-term heart issues after COVID-19.

Area of Science:

  • Cardiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Long coronavirus disease 2019 (COVID-19) is characterized by persistent symptoms, including dyspnea, in recovered patients.
  • The underlying mechanisms of long COVID, particularly cardiac involvement, remain incompletely understood.
  • Subclinical cardiac dysfunction may contribute to persistent dyspnea after COVID-19 infection.

Purpose of the Study:

  • To investigate subclinical cardiac dysfunction using transthoracic echocardiography (TTE) in recovered COVID-19 patients.
  • To assess the association between cardiac function parameters and the presence of dyspnea one year after COVID-19.
  • To identify potential echocardiographic markers predictive of persistent dyspnea in long COVID.

Main Methods:

  • Prospective inclusion of 310 COVID-19 patients, with 66 patients without prior cardiopulmonary diseases undergoing one-year follow-up.
  • Follow-up included clinical evaluation, spirometry, chest computed tomography, and TTE to assess cardiac function.
  • Comparison of TTE parameters, including left ventricle (LV) ejection fraction, LV global longitudinal strain, global constructive work (GCW), and global work index (GWI), between patients with and without dyspnea.

Main Results:

  • Persistent dyspnea was reported by 34.8% of patients one year post-COVID-19.
  • Patients with dyspnea showed significantly lower LV global longitudinal strain, GCW, and GWI compared to asymptomatic patients.
  • GCW and GWI were independently associated with the presence of dyspnea, suggesting impaired myocardial performance.

Conclusions:

  • Persistent dyspnea is a common sequela of COVID-19, affecting over a third of recovered patients.
  • Reduced global constructive work and global work index are significant echocardiographic indicators of subclinical cardiac dysfunction in long COVID patients with dyspnea.
  • These findings highlight the role of myocardial impairment in the pathophysiology of long COVID-related dyspnea.

Keywords:
echocardiographyglobal longitudinal strainlong COVID-19myocardial workpersistent dyspneasubclinical dysfunction

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