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

Prashant K Minocha1, Ranjini Srinivasan1,2, James Babb2

  • 1Division of Pediatric Cardiology, Hassenfeld Children's Hospital at NYU Langone and New York University Grossman School of Medicine, New York, USA.

Annals of Pediatric Cardiology
|May 8, 2023
PubMed

Insights

Cardiac injury in children with COVID-19 and MIS-C can be detected by echocardiographic strain. This sensitive measure reveals subtle myocardial dysfunction, even with preserved ejection fraction, aiding diagnosis and follow-up.

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.
Abstract

Keywords:
COVID-19SARS-CoV-2multisystem inflammatory syndrome in childrenpediatricsspeckle-tracking echocardiographystrain

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