TY - JOUR
T1 - Prominent Longitudinal Strain Reduction of Basal Left Ventricular Segments in Patients With Coronavirus Disease-19
AU - Goerlich, Erin
AU - Gilotra, Nisha A.
AU - Minhas, Anum S.
AU - Bavaro, Nicole
AU - Hays, Allison G.
AU - Cingolani, Oscar H.
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2021/1
Y1 - 2021/1
N2 - Background: Coronavirus disease-19 (COVID-19) has been associated with overt and subclinical myocardial dysfunction. We observed a recurring pattern of reduced basal left ventricular (LV) longitudinal strain on speckle-tracking echocardiography in hospitalized patients with COVID-19 and subsequently aimed to identify characteristics of affected patients. We hypothesized that patients with COVID-19 with reduced basal LV strain would demonstrate elevated cardiac biomarkers. Methods and Result: Eighty-one consecutive patients with COVID-19 underwent speckle-tracking echocardiography. Those with poor quality speckle-tracking echocardiography (n = 2) or a known LV ejection fraction of <50% (n = 4) were excluded. Patients with an absolute value basal longitudinal strain of <13.9% (2 standard deviations below normal) were designated as cases (n = 39); those with a basal longitudinal strain of ≥13.9% were designated as controls (n = 36). Demographics and clinical variables were compared. Of 75 included patients (mean age 62 ± 14 years, 41% women), 52% had reduced basal strain. Cases had higher body mass index (median 34.1; interquartile range 26.5–37.9 kg/m2 vs median 26.9, interquartile range, 24.8–30.0 kg/m2, P =.009), and greater proportions of Black (74% vs 36%, P =.0009), hypertensive (79% vs 56%, P =.026), and diabetic patients (44% vs 19%, P =.025) compared with controls. Troponin and N-terminal pro-brain natriuretic peptide levels trended higher in cases, but were not significantly different. Conclusions: Reduced basal LV strain is common in patients with COVID-19. Patients with hypertension, diabetes, obesity, and Black race were more likely to have reduced basal strain. Further investigation into the significance of this strain pattern is warranted.
AB - Background: Coronavirus disease-19 (COVID-19) has been associated with overt and subclinical myocardial dysfunction. We observed a recurring pattern of reduced basal left ventricular (LV) longitudinal strain on speckle-tracking echocardiography in hospitalized patients with COVID-19 and subsequently aimed to identify characteristics of affected patients. We hypothesized that patients with COVID-19 with reduced basal LV strain would demonstrate elevated cardiac biomarkers. Methods and Result: Eighty-one consecutive patients with COVID-19 underwent speckle-tracking echocardiography. Those with poor quality speckle-tracking echocardiography (n = 2) or a known LV ejection fraction of <50% (n = 4) were excluded. Patients with an absolute value basal longitudinal strain of <13.9% (2 standard deviations below normal) were designated as cases (n = 39); those with a basal longitudinal strain of ≥13.9% were designated as controls (n = 36). Demographics and clinical variables were compared. Of 75 included patients (mean age 62 ± 14 years, 41% women), 52% had reduced basal strain. Cases had higher body mass index (median 34.1; interquartile range 26.5–37.9 kg/m2 vs median 26.9, interquartile range, 24.8–30.0 kg/m2, P =.009), and greater proportions of Black (74% vs 36%, P =.0009), hypertensive (79% vs 56%, P =.026), and diabetic patients (44% vs 19%, P =.025) compared with controls. Troponin and N-terminal pro-brain natriuretic peptide levels trended higher in cases, but were not significantly different. Conclusions: Reduced basal LV strain is common in patients with COVID-19. Patients with hypertension, diabetes, obesity, and Black race were more likely to have reduced basal strain. Further investigation into the significance of this strain pattern is warranted.
KW - COVID-19, strain
KW - Echocardiography
KW - myocardial dysfunction
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U2 - 10.1016/j.cardfail.2020.09.469
DO - 10.1016/j.cardfail.2020.09.469
M3 - Article
C2 - 32991982
AN - SCOPUS:85096864099
SN - 1071-9164
VL - 27
SP - 100
EP - 104
JO - Journal of cardiac failure
JF - Journal of cardiac failure
IS - 1
ER -