Strain Echocardiographic Evaluation of Myocardial Involvement in Patients with Continuing Chest Pain after COVID-19
Emre Özdemir1, Uğur Karagöz2, Sadık Volkan Emren1
1Departamento da Cardiologia, Faculdade de Medicina, Atatürk Research and Training Hospital, Katip Çelebi University, Izmir - Turquia.
Insights
Strain echocardiography (SE) effectively detects myocardial involvement in post-COVID-19 patients. Global longitudinal strain (GLS) and global circumferential strain (GCS) show high sensitivity and specificity for diagnosing cardiac sequelae, aiding timely treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Post or long coronavirus disease (p/l COVID) can cause myocardial injury and cardiac problems.
- Diagnosing cardiac involvement in p/l COVID patients is crucial due to rising case numbers.
Purpose of the Study:
- To evaluate the diagnostic value of strain echocardiography (SE) for detecting myocardial involvement in p/l COVID patients.
- To compare SE parameters with cardiac magnetic resonance (CMR) findings in patients with atypical chest pain and suspected myocarditis.
Main Methods:
- 42 p/l COVID patients were divided into two groups based on CMR findings: CMR(-) (n=21) and CMR(+) (n=21).
- Strain echocardiography (SE) parameters, including global longitudinal strain (GLS) and global circumferential strain (GCS), were compared between groups.
- Multivariate analysis assessed the predictive value of SE for myocarditis.
Main Results:
- GLS and GCS demonstrated a stronger correlation with myocardial involvement than left ventricular ejection fraction (LVEF).
- GLS < 20.35 (85.7% sensitivity, 81% specificity) and GCS < 21.35 (81% sensitivity, 81% specificity) were effective diagnostic values for myocardial sequelae.
- Biochemical markers like brain natriuretic peptide showed significant differences (p < 0.001), unlike inflammatory markers (C-reactive protein, p = 0.31).
Conclusions:
- Strain echocardiography is a valuable tool for rapid and accurate diagnosis of myocardial involvement in p/l COVID.
- SE enables quicker diagnosis than traditional echocardiography, facilitating prompt treatment initiation for cardiac complications.
Background:
A new clinical manifestation called post or long coronavirus disease (p/l COVID) has walked into our lives after the acute COVID-19 phase. P/l COVID may lead to myocardial injury with subsequent cardiac problems. Diagnosing these patients quickly and simply has become more important due to the increasing number of patients with p/l COVID.
Objectives:
We compared strain echocardiography (SE) parameters of patients who suffered from atypical chest pain and had sequel myocarditis findings on cardiac magnetic resonance (CMR). We aimed to investigate the value of SE for detection of myocardial involvement in patients with p/l COVID.
Methods:
A total of 42 patients were enrolled. Our population was separated into two groups. The CMR(-) group (n = 21) had no myocardial sequelae on CMR, whereas the CMR(+) group had myocardial sequelae on CMR (n = 21). The predictive value of SE for myocarditis was also evaluated by age-adjusted multivariate analysis. P values < 0.05 were considered statistically significant.
Results:
When compared with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and global circumferential strain (GCS) had a stronger relationship (LVEF, p = 0.05; GLS, p < 0.001; GCS, p < 0.001) with p/l COVID associated myocardial involvement. GLS < 20.35 had 85.7% sensitivity and 81% specificity; GCS < 21.35 had 81% sensitivity and 81% specificity as diagnostic values for myocardial sequelae detected with CMR. While there was no difference between the groups in terms of inflammatory markers (C-reactive protein, p = 0.31), a difference was observed between biochemical markers, which are indicators of cardiac involvement (brain natriuretic peptide, p < 0.001).
Conclusion:
SE is more useful than traditional echocardiography for making diagnosis quickly and accurately in order not to delay treatment in the presence of myocardial involvement.
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