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 - Funding Information:
Dr. Goerlich is supported by the Ruth L. Kirschstein Institutional National Research Service Award; T32HL007227-Pathophysiology of Myocardial Disease. Dr. Minhas is supported by the National Heart, Lung, and Blood Institute training grant T32HL007024. Dr. Hays is supported by the Magic that Matters Fund of Johns Hopkins Medicine and NIH/NHLBI 1R01HL147660. Dr. Cingolani is supported by the Magic that Matters Fund, and the Michel Mirowski Discovery Award, Johns Hopkins Medicine.
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
VL - 27
SP - 100
EP - 104
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 1
ER -