Cardiac Phenotyping of SARS-CoV-2 in British Columbia: A Prospective Echo Study With Strain Imaging
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul’s Hospital. At 4–18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson’s, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4–18 weeks post diagnosis, but over half had abnormal LV GLS.
Abstract
BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul’s Hospital. At 4–18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson’s, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4–18 weeks post diagnosis, but over half had abnormal LV GLS.
참고문헌 (30)
- Dong E, "An interactive web-based dashboard to track COVID-19 in real time", Lancet Infect Dis, 20, pp.533~534 (2020)
- Clark A, "Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020 : a modelling study", Lancet Glob Health, 8, pp.e1003~e1017 (2020)
- Clerkin KJ, "COVID-19 and cardiovascular disease", Circulation, 141, pp.1648~1655 (2020)
- Dweck MR, "Global evaluation of echocardiography in patients with COVID-19", Eur Heart J Cardiovasc Imaging, 21, pp.949~958 (2020)
- Jung Hyun Choi, "Things You Should Know in the Performing Echocardiographic Examination in Patients with COVID-19", Journal of Cardiovascular Imaging, 29(1), pp.20~30 (2021), 한국심초음파학회[DOI]
- Zouheir Ibrahim Bitar, "Point-of-Care Ultrasound for COVID-19 Pneumonia Patients in the ICU", Journal of Cardiovascular Imaging, 29(1), pp.60~68 (2021), 한국심초음파학회[DOI]
- Collier P, "A test in context : myocardial strain measured by speckle-tracking echocardiography", J Am Coll Cardiol, 69, pp.1043~1056 (2017)
- Lang RM, "Recommendations for cardiac chamber quantification by echocardiography in adults : an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging", J Am Soc Echocardiogr, 28, pp.1~39 (2015)[DOI]
- Di Stefano C, "Diagnostic and predictive value of speckle tracking echocardiography in cardiac sarcoidosis", BMC Cardiovasc Disord, 20, pp.21~ (2020)
- Sonnweber T, "Cardiopulmonary recovery after COVID-19 : an observational prospective multicentre trial", Eur Respir J, 57, pp.2003481~ (2021)
- Sechi LA, "Short-term cardiac outcome in survivors of COVID-19 : a systematic study after hospital discharge", Clin Res Cardiol, 110, pp.1063~1072 (2021)
- Zhou M, "Cardiovascular sequalae in uncomplicated COVID-19 survivors", PLoS One, 16, pp.e0246732~ (2021)
- Lassen MC, "Echocardiographic abnormalities and predictors of mortality in hospitalized COVID-19 patients : the ECHOVID-19 study", ESC Heart Fail, 7, pp.4189~4197 (2020)
- Bursi F, "Prognostic utility of quantitative offline 2D-echocardiography in hospitalized patients with COVID-19 disease", Echocardiography, 37, pp.2029~2039 (2020)
- Li X, "Elevated extracellular volume fraction and reduced global longitudinal strains in participants recovered from COVID-19 without clinical cardiac findings", Radiology, 299, pp.E230~E240 (2021)
- Ozer PK, "Impairment of right ventricular longitudinal strain associated with severity of pneumonia in patients recovered from COVID-19", Int J Cardiovasc Imaging, 37, pp.2387~2397 (2021)
- Sperry BW, "Regional variability in longitudinal strain across vendors in patients with cardiomyopathy due to increased left ventricular wall thickness", Circ Cardiovasc Imaging, 12, pp.e008973~ (2019)
- Faqihi F, "Reverse takotsubo cardiomyopathy in fulminant COVID-19 associated with cytokine release syndrome and resolution following therapeutic plasma exchange : a case-report", BMC Cardiovasc Disord, 20, pp.389~ (2020)
- Sala S, "Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection", Eur Heart J, 41, pp.1861~1862 (2020)
- Shmueli H, "Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19", Int J Cardiol Heart Vasc, 32, pp.100719~ (2021)
- Huang L, "Cardiac involvement in patients recovered from COVID-2019 identified using magnetic resonance imaging", JACC Cardiovasc Imaging, 13, pp.2330~2339 (2020)
- Friedrich MG, "Cardiovascular magnetic resonance in myocarditis : A JACC White Paper", J Am Coll Cardiol, 53, pp.1475~1487 (2009)
- Lala A, "Prevalence and impact of myocardial injury in patients hospitalized with COVID-19 infection", J Am Coll Cardiol, 76, pp.533~546 (2020)
- Oudit GY, "SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS", Eur J Clin Invest, 39, pp.618~625 (2009)
- Liu PP, "The science underlying COVID-19 : implications for the cardiovascular system", Circulation, 142, pp.68~78 (2020)
- Lindner D, "Association of cardiac infection with SARS-CoV-2 in confirmed COVID-19 autopsy cases", JAMA Cardiol, 5, pp.1281~1285 (2020)
- Musher DM, "Acute infection and myocardial infarction", N Engl J Med, 380, pp.171~176 (2019)
- Peng W, "Mechanisms and treatments of myocardial injury in patients with corona virus disease 2019", Life Sci, 262, pp.118496~ (2020)
- Kwong JC, "Acute myocardial infarction after laboratory-confirmed influenza infection", N Engl J Med, 378, pp.345~353 (2018)
- Giustino G, "Coronavirus and cardiovascular disease, myocardial injury, and arrhythmia : JACC focus seminar", J Am Coll Cardiol, 76, pp.2011~2023 (2020)