Strain in children with MIS-C and acute COVID-19

Area of Science:

• Cardiology
• Pediatric Infectious Diseases
• Echocardiography

Background:

• Cardiac injury is a known complication of acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C).
• Echocardiographic strain is a sensitive indicator of systolic function.

Purpose of the Study:

• To describe echocardiographic strain findings in children with acute COVID-19 and MIS-C.
• To evaluate strain in relation to left ventricular ejection fraction (LVEF) and serum troponin levels.

Main Methods:

• Retrospective analysis of echocardiograms from patients with acute COVID-19 and MIS-C.
• Strain analysis using TOMTEC software compared to age-matched healthy controls.
• Correlation of strain with LVEF and troponin levels.

Main Results:

• Patients with MIS-C and acute COVID-19 showed significantly decreased LV longitudinal strain, LV circumferential strain, and left atrial strain compared to controls.
• Abnormal strain was present in patients with preserved LVEF, indicating subtle myocardial dysfunction.
• LV longitudinal strain correlated with troponin levels in MIS-C patients.
• Abnormal strain persisted in one-third of patients at follow-up.

Conclusions:

• Echocardiographic strain effectively detects myocardial dysfunction in pediatric COVID-19 and MIS-C.
• Strain analysis is a valuable tool for diagnosing and monitoring cardiac involvement in these conditions.
• Strain may identify subclinical cardiac injury not evident by LVEF alone.