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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left Ventricular Global Longitudinal Strain in Patients With COVID-19 Infection
Harneet Bhatti1, Andres Cordova Sanchez1, Rajat Dhungana2
1Internal Medicine, State University of New York Upstate Medical University, Syracuse, USA.
Insights
Transthoracic echocardiography measuring left ventricular global longitudinal strain (LVGLS) can predict mortality in COVID-19 patients. Reduced LVGLS indicates higher mortality risk, even in survivors, suggesting subclinical cardiac dysfunction.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic with significant cardiovascular implications.
- Cardiovascular damage is frequently observed in COVID-19 patients.
- Subclinical cardiac dysfunction may precede clinical symptoms.
Purpose of the Study:
- To investigate left ventricular global longitudinal strain (LVGLS) as a prognostic marker for COVID-19 patients.
- To determine if reduced LVGLS is associated with an increased risk of mortality in COVID-19 survivors.
Main Methods:
- Utilized transthoracic echocardiography to measure LVGLS in COVID-19 patients.
- Compared LVGLS values between survivors and non-survivors.
- Performed multivariate logistic regression analysis to assess the relationship between LVGLS and mortality.
Main Results:
- Non-survivors exhibited significantly lower mean LVGLS compared to survivors (-11.6 ± 1.8 vs -15.4 ± 0.74, p<0.05).
- Reduced LVGLS was observed even in surviving COVID-19 patients (<-18.5%).
- A significant association was found between reduced LVGLS and increased mortality risk.
Conclusions:
- COVID-19 patients may experience subclinical left ventricular dysfunction.
- LVGLS is a potential prognostic marker for mortality in COVID-19.
- Critically ill patients may show a more pronounced decline in cardiac function.
Abstract:
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, is an ongoing pandemic that has affected millions globally. Many infected patients have been noted to have cardiovascular damage. Prior to the development of clinical symptoms, the use of transthoracic echocardiography, specifically with measurements of left ventricular global longitudinal strain (LVGLS), may provide an additional prognostic marker for patients infected with COVID-19. We sought to determine whether patients with COVID-19 and reduced LVGLS have an increased risk for mortality. The mean LVGLS was determined to be significantly lower in the non-survivors compared to the survivors (-11.6 ± 1.8 vs -15.4 ± 0.74, p<0.05). It should be noted, however, that even those that survived were found to have reduced LVGLS (<-18.5%). A multivariate logistic regression analysis was also performed that demonstrated a relationship between reduced LVGLS and an increased risk for mortality. Overall, our data indicate that COVID-19 patients may have subclinical left ventricular dysfunction, and that critically ill patients may have a greater decline in cardiac dysfunction.
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