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Can Global Longitudinal Strain Assess Asymptomatic Subtle Left Ventricular Dysfunction in Recovered COVID-19
Hazem Mansour1, Aly Osama Abdelhady1, Walaa Adel Abdel Reheim1
1Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
Subtle left ventricular (LV) dysfunction may persist after mild COVID-19 infection, even with normal ejection fraction. Global longitudinal strain (GLS) detected this subclinical cardiac issue in recovered patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Echocardiography
Background:
- Coronavirus disease 2019 (COVID-19) can cause multisystem inflammation, potentially affecting cardiac function.
- While often preserved, left ventricular (LV) function may exhibit subtle impairments post-COVID-19.
- Cytokine storms associated with COVID-19 are implicated in cardiac injury.
Purpose of the Study:
- To investigate subtle left ventricular (LV) dysfunction in COVID-19 survivors.
- To utilize global longitudinal strain (GLS) as a sensitive marker for LV dysfunction.
- To assess cardiac function in patients recently recovered from mild to moderate COVID-19.
Main Methods:
- A single-center observational study included 90 stable patients post-mild to moderate COVID-19.
- Transthoracic echocardiography was performed on all participants.
- Global longitudinal strain (GLS) was measured to evaluate LV function.
Main Results:
- All patients exhibited normal LV dimensions and ejection fractions.
- A significant proportion (33.3%) demonstrated subclinical LV dysfunction, indicated by reduced GLS.
- Reduced GLS correlated significantly with elevated troponin and C-reactive protein levels.
Conclusions:
- Mild to moderate COVID-19 infection can lead to subclinical left ventricular (LV) dysfunction.
- Reduced global longitudinal strain (GLS) is a key indicator of this post-COVID-19 cardiac alteration.
- Early detection of LV dysfunction using GLS may be crucial for managing cardiovascular sequelae.
Background:
Coronavirus disease 2019 (COVID-19) might be associated with cardiac injury as a part of multisystem affection in response to cytokine storms. However, left ventricular (LV) function appears preserved in most of the cases, whereas subtle LV dysfunction might happen in others. Hence, we tried to detect subtle LV dysfunction in patients with COVID-19 using global longitudinal strain (GLS).
Patients And Methods:
We performed a single-center observational study on 90 stable patients who were recently recovered from mild to moderate COVID-19 infections. A transthoracic echocardiographic examination was done for all patients, and GLS assessment was used as an indicator of LV function.
Results:
The population age ranged from 27 to 66 years, and the majority of patients were males (54, 73.3%). Besides, 46.7% of the included patients were smokers, 33.3% had hypertension, and 23.3% were diabetics. All the patients had normal LV internal dimensions and ejection fractions. However, 33.3% of them had subclinical LV dysfunction as expressed by reduced GLS. There was no statistically significant correlation between GLS and age, gender, or other risk factors, whereas troponin and C-reactive protein significantly correlated with GLS.
Conclusions:
Recovered patients from recent mild to moderate COVID-19 infections might show subtle LV dysfunction as manifested by reduced GLS.
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