Objectives: Myocardial injury during active coronavirus disease-2019 (COVID-19) infection is well described however, its persistence during recovery is unclear. We assessed left ventricle (LV) global longitudinal strain (GLS) using speckle tracking echocardiography (STE) in COVID-19 recovered patients and studied its correlation with various parameters.Methods: A total of 134 subjects within 30-45 days post recovery from COVID-19 infection and normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers (on admission) and comprehensive echocardiography including STE were done for all. Results: Of the 134 subjects, 121 (90.3%) were symptomatic during COVID-19 illness and were categorized as mild: 61 (45.5%), moderate: 50 (37.3%) and severe: 10 (7.5%) COVID-19 illness. Asymptomatic COVID-19 infection was reported in 13 (9.7%) patients. Subclinical LV and right ventricle (RV) dysfunction were seen in 40 (29.9%) and 14 (10.5%) patients respectively. Impaired LVGLS was reported in 1 (7.7%), 8 (13.1%), 22 (44%) and 9 (90%) subjects with asymptomatic, mild, moderate and severe disease respectively. LVGLS was significantly lower in patients recovered from severe illness (mild: -21 ± 3.4%; moderate: -18.1 ± 6.9%; severe: -15.5 ± 3.1%; P < 0.0001). Subjects with reduced LVGLS had significantly higher interleukin-6 (P < 0.0001), C-reactive protein (P = 0.001), lactate dehydrogenase (P = 0.009) and serum ferritin (P = 0.03) levels during index admission. Conclusions: Subclinical LV dysfunction was seen in nearly a third of recovered COVID-19 patients while 10.5% had RV dysfunction. Our study suggests a need for closer follow-up among COVID-19 recovered subjects to elucidate long-term cardiovascular outcomes.

Aim: The aim of this study was to assess the left atrial (LA) function in severe rheumatic mitral stenosis (MS) patients using two-dimensional speckle tracking echocardiography (STE) and its correlation with clinical symptoms and echocardiography parameters. Methods: A total of 120 subjects (80 patients with isolated severe MS [mitral valve area (MVA) ≤1.5 cm2] in sinus rhythm and 40 healthy controls) underwent comprehensive echocardiography including STE for assessment of LA strain [reservoir strain (LASr), conduit strain (LAScd) and contractile strain (LASct)]. Results: The mean MVA in cases was 0.93 ± 0.21 cm2. The mean values of LASr (14.73 ± 8.59%), LAScd (-7.61 ± 4.47%) and LASct (-7.16 ± 5.15%) among cases were significantly less (p< 0.001) when compared to controls where the values were 44.11 ± 10.44%, -32.45 ± 7.63%, -11.85 ± 6.77% respectively. Thus the compensatory LA contractile function was also compromised. The New York Heart Association (NYHA) class III, II and I dyspnea was present in 37 (46.25%), 38 (47.5%) and 5 (6.25%) subjects respectively. All the three LA strain parameters showed a trend towards decline with increase in severity of MS, increase in LA size, increase in mean and peak diastolic transmitral gradients and with higher NYHA functional class. Conclusion: Left atrial dysfunction is common in severe rheumatic MS as suggested by severely reduced LA reservoir, conduit and contractile strain. Early and timely intervention in these patients irrespective of NYHA functional class is advocated as it may likely improve the LA function and avoid clinical deterioration.