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Evaluation of myocardial performance index in patients with COVID-19: An echocardiographic follow-up study
Hakan Kaya1, Ramazan Asoglu1, Abdulmecit Afsin2
1Department of Cardiology, Adiyaman Training and Research Hospital, Adiyaman, Turkey.
Insights
COVID-19 patients show impaired cardiac diastolic function, indicated by a higher myocardial performance index (MPI). This diastolic dysfunction is reversible upon clinical recovery, suggesting potential for monitoring and treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Diagnostics
Background:
- Cytokine-mediated immune reactions can impair myocardial performance.
- The myocardial performance index (MPI) is a valuable echocardiographic parameter for assessing systolic and diastolic cardiac function.
- Understanding cardiac function in COVID-19 is crucial for patient management.
Purpose of the Study:
- To evaluate the myocardial performance index (MPI) in patients diagnosed with COVID-19.
- To compare cardiac function parameters between COVID-19 patients and healthy controls.
- To assess the reversibility of cardiac function changes after clinical recovery from COVID-19.
Main Methods:
- Echocardiographic examination was performed on 40 healthy controls and 40 mild COVID-19 patients.
- MPI, isovolumic relaxation time (IRT), deceleration time (DT), ejection time (ET), and E/A ratio were measured.
- Comparisons were made between controls and patients during acute infection, and between acute infection and post-recovery periods.
Main Results:
- COVID-19 patients exhibited significantly higher MPI, longer IRT, longer DT, shorter ET, and higher E/A ratio compared to controls.
- These diastolic function impairments were significantly more pronounced during the acute infection phase than after clinical recovery.
- Left ventricular ejection fraction remained similar across all groups, indicating preserved systolic function.
Conclusions:
- Patients with COVID-19 may experience subclinical diastolic cardiac impairment.
- This diastolic dysfunction appears to be reversible following clinical recovery from the infection.
- MPI serves as a sensitive indicator of cardiac involvement in COVID-19.
Introduction And Objectives:
Myocardial performance may be impaired in cytokine-mediated immune reactions. The myocardial performance index (MPI) is a practical parameter that reflects systolic and diastolic cardiac function. We aimed to assess the MPI in patients with COVID-19.
Methods:
The study population consisted of 40 healthy controls and 40 patients diagnosed with COVID-19 who had mild pneumonia and did not need intensive care treatment. All participants underwent echocardiographic examination. First, the MPI and laboratory parameters were compared between healthy controls and patients in the acute period of infection. Second, the MPI and laboratory parameters were compared between the acute infection period and after clinical recovery.
Results:
Compared with healthy controls, patients with COVID-19 had a significantly higher MPI (0.56±0.09 vs. 0.41±0.06, p<0.001), longer isovolumic relaxation time (IRT) (112.3±13.4 vs. 90.6±11.2 ms, p<0.001), longer deceleration time (DT) (182.1±30.6 vs. 160.8±42.7 ms, p=0.003), shorter ejection time (ET) (279.6±20.3 vs. 299.6±34.7 ms, p<0.001) and higher E/A ratio (1.53±0.7 vs. 1.21±0.3, p<0.001). Statistically significantly higher MPI (0.56±0.09 vs. 0.44±0.07, p<0.001), longer IRT (112.3±13.4 vs. 91.8±12.1 ms, p<0.001), longer DT (182.1±30.6 vs. 161.5±43.5 ms, p=0.003), shorter ET 279.6±20.3 vs. 298.8±36.8 ms, p<0.001) and higher E/A ratio (1.53±0.7 vs. 1.22±0.4, p<0.001) were observed during the acute infection period than after clinical recovery. Left ventricular ejection fraction was similar in the controls, during the acute infection period and after clinical recovery.
Conclusions:
Subclinical diastolic impairment without systolic involvement may be observed in patients with COVID-19. This impairment may be reversible on clinical recovery.
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