Reduced Circumferential Strain in Athletes with Prior COVID-19

Area of Science:

• Cardiology
• Infectious Diseases
• Sports Medicine

Background:

• Cardiac magnetic resonance imaging (CMR) is crucial for assessing heart health.
• The impact of SARS-CoV-2 infection on cardiac function in athletes requires further investigation.
• Circumferential systolic strain (CS) is a key indicator of myocardial contractility.

Purpose of the Study:

• To evaluate global and segmental circumferential systolic strain (CS) using cardiac MRI in athletes post-SARS-CoV-2 infection.
• To compare CS measurements between athletes with and without a history of SARS-CoV-2 infection.
• To investigate the association between SARS-CoV-2 infection and cardiac strain in an athletic population.

Main Methods:

• Retrospective observational cohort study comparing 188 SARS-CoV-2 positive (C19+) athletes with 72 SARS-CoV-2 negative (C19-) athletes.
• Cardiac MRI with feature tracking was used to measure global and segmental CS.
• Statistical models (unadjusted and multivariable-adjusted) were employed for group comparisons, with myocarditis diagnosed by modified Lake Louise criteria.

Main Results:

• A statistically significant reduction in global CS was observed in C19+ athletes compared to C19- athletes (p = .009).
• This difference persisted after adjusting for covariates, indicating a direct association with SARS-CoV-2 infection.
• Specific myocardial segments (basal- and mid- inferoseptal, septal, inferolateral) showed significant differences in CS and higher rates of late gadolinium enhancement in C19+ athletes.

Conclusions:

• SARS-CoV-2 infection is associated with a small but significant decrease in CS among athletes.
• These findings suggest subclinical cardiac effects of COVID-19 on athletic heart function, even after mild infections.
• The observed changes in CS and late gadolinium enhancement warrant further research into long-term cardiovascular implications for athletes.