Different cardiac performance in severe and mild patients with COVID-19
by standard and strain echocardiography
Abstract
Background: The initial mechanism of COVID-19 is the binding of the
virus to ACE2. Since the heart and the vessels also express ACE2, they
both could become targets of the virus. However, cardiac performance of
mild and severe patients may be different, requested individualized
treatment. The aim of this study is to explore the global and segmental
myocardial performance of the severe and mild COVID-19 patients.Methods:
45 patients with COVID-19 infection were included in this study. The
clinical history, laboratory test and standard and strain
echocardiography were performed at admission. Results: 1. All patients
showed reduced cardiac diastolic function; 2. Severe patients exhibited
exacerbated right ventricular systolic function; 3. All patients showed
impaired left ventricular strain, worse strain in severe patient. 4. The
apical longitudinal strain of mild patients was higher than basal and
middle segment. 5. There was a negative correlation between LV GLS and
log TnT-hs, as well as NT-pro BNP. 6. The EF value and strain of left
atrium of mild and severe patients decreased; 7. LV GLS, LV GCS and LA
GLS area under the ROC curve to predict the disease severity were 0.698,
0.758 and 0.782 respectively. 8. In the follow-up of severe patients,
left atrial and ventricular strain showed an increased
trend.Conclusions: These findings suggested that left ventricular
performance was subclinically impaired during COVID-9 infection
irrespective of infection severity and the strain of LV and LA may
predict the disease severity. The cardiac function had an increasing
trend for severe patients.