Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19

Shmueli, Hezzy; Shah, Maulin; Ebinger, Joseph; Nguyen, Long-Co; Chernomordik, Fernando; Flint, Nir; Botting, Patrick; Siegel, Robert J.

doi:10.1016/j.ijcha.2021.100719

Cited by 35 publications

(47 citation statements)

References 43 publications

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“…WMA reporting has been variable among studies with incidence ranging from 14% to 26% among patients with COVID-19 who underwent ECHO, 50,62 and has shown to correlate with biochemical injury of the myocardium. 63,64 WMA was more frequently observed in the mid and apical segments followed by basal segments.…”

Section: Wall Motion Abnormality (Wma)mentioning

confidence: 99%

Echocardiography, lung ultrasound, and cardiac magnetic resonance findings in COVID‐19: A systematic review

Barssoum

Victor²,

Salem

et al. 2021

Echocardiography

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Background:The manifestations of COVID-19 as outlined by imaging modalities such as echocardiography, lung ultrasound (LUS), and cardiac magnetic resonance (CMR) imaging are not fully described. Methods:We conducted a systematic review of the current literature and included studies that described cardiovascular manifestations of COVID-19 using echocardiography, CMR, and pulmonary manifestations using LUS. We queried PubMed, EMBASE, and Web of Science for relevant articles. Original studies and case series were included.Results: This review describes the most common abnormalities encountered on echocardiography, LUS, and CMR in patients infected with COVID-19.

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Section: Wall Motion Abnormality (Wma)mentioning

confidence: 99%

Echocardiography, lung ultrasound, and cardiac magnetic resonance findings in COVID‐19: A systematic review

Barssoum

Victor²,

Salem

et al. 2021

Echocardiography

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“…[84][85][86] Cardiovascular imaging may offer several advantages in non-invasively evaluating COVID and non-COVID patients with cardiac symptoms during the COVID-19 pandemic (Figure 2). 48,87,88 Newer echocardiography techniques, such as LV global longitudinal strain, may uncover subclinical myocardial dysfunction in a large proportion (*80%) of patients hospitalized with COVID-19, while gross LV dysfunction with decreased LV ejection fraction and wall motion abnormalities are less frequent findings (22%-23%). 87 Myocardial strain imaging may detect myocardial dysfunction in almost all critically ill COVID-19 patients.…”

Section: Non-covid-19 Patientsmentioning

confidence: 99%

“…48,87,88 Newer echocardiography techniques, such as LV global longitudinal strain , may uncover subclinical myocardial dysfunction in a large proportion (∼80%) of patients hospitalized with COVID-19, while gross LV dysfunction with decreased LV ejection fraction and wall motion abnormalities are less frequent findings (22%-23%). 87 Myocardial strain imaging may detect myocardial dysfunction in almost all critically ill COVID-19 patients. 89 Nevertheless, in the majority, if not all, patients, coronary angiography will be needed to visualize the coronary arteries; in those with non-significant or absent coronary lesions, it would be advisable to perform LV angiography that could hasten and confirm certain diagnoses, like TTC.…”

Section: Non-covid-19 Patientsmentioning

confidence: 99%

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Manolis¹,

Manolis

et al. 2021

J Cardiovasc Pharmacol Ther

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In the era of the coronavirus disease 2019 (COVID-19) pandemic, acute cardiac injury (ACI), as reflected by elevated cardiac troponin above the 99th percentile, has been observed in 8%-62% of patients with COVID-19 infection with highest incidence and mortality recorded in patients with severe infection. Apart from the clinically and electrocardiographically discernible causes of ACI, such as acute myocardial infarction (MI), other cardiac causes need to be considered such as myocarditis, Takotsubo syndrome, and direct injury from COVID-19, together with noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis. Acute coronary syndromes (ACS) with normal or near-normal coronary arteries (ACS-NNOCA) appear to have a higher prevalence in both COVID-19 positive and negative patients in the pandemic compared to the pre-pandemic era. Echocardiography, coronary angiography, chest computed tomography and/or cardiac magnetic resonance imaging may render a correct diagnosis, obviating the need for endomyocardial biopsy. Importantly, a significant delay has been recorded in patients with ACS seeking advice for their symptoms, while their routine care has been sharply disrupted with fewer urgent coronary angiographies and/or primary percutaneous coronary interventions performed in the case of ST-elevation MI (STEMI) with an inappropriate shift toward thrombolysis, all contributing to a higher complication rate in these patients. Thus, new challenges have emerged in rendering a diagnosis and delivering treatment in patients with ACI/ACS in the pandemic era. These issues, the various mechanisms involved in the development of ACI/ACS, and relevant current guidelines are herein reviewed.

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“…The main parameters used to determine COVID-19-induced cardiac injury in clinical practice are increased serum troponin levels and an overt reduction in left ventricular ejection fraction (LVEF) on the transthoracic echocardiography (ECHO) and reported in 8% to 28% of patients [7,8]. However, in recent studies using more sensitive diagnostic methods that can detect subclinical myocardial damage, such as cardiac magnetic resonance imaging (MRI) and 2-D left ventricular-global longitudinal strain (LV-GLS), reported cardiac involvement reached 80% [9,10].…”

Section: Introductionmentioning

confidence: 99%

Left ventricular global longitudinal strain in low cardiac risk outpatients who recently recovered from coronavirus disease 2019

Turhan

Özderya

Şahin

et al. 2021

Int J Cardiovasc Imaging

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The cardiac sequelae of coronavirus disease 2019 , a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.

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Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19

Cited by 35 publications

References 43 publications

Echocardiography, lung ultrasound, and cardiac magnetic resonance findings in COVID‐19: A systematic review

Echocardiography, lung ultrasound, and cardiac magnetic resonance findings in COVID‐19: A systematic review

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Left ventricular global longitudinal strain in low cardiac risk outpatients who recently recovered from coronavirus disease 2019

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