Abnormal Left Ventricular Global Longitudinal Strain By Speckle Tracking Echocardiography in COVID-19 Patients

Abstract

COVID-19 infection can affect the cardiovascular system. We sought to determine if left ventricular global longitudinal strain (LVGLS) is affected by COVID-19 and if this has prognostic implications. Materials & methods: Retrospective study, with LVGLS was measured in 58 COVID-19 patients. Patients discharged were compared with those who died. Results: The mean LV ejection fraction (LVEF) and LVGLS for the cohort was 52.1 and -12.9 ± 4.0%, respectively. Among 30 patients with preserved LVEF (>50%), LVGLS was -15.7 ± 2.8%, which is lower than the reference mean LVGLS for a normal, healthy population. There was no significant difference in LVGLS or LVEF when comparing patients who survived to discharge or died. Conclusion: LVGLS was reduced in COVID-19 patients, although not significantly lower in those who died compared with survivors.

Lay abstract

COVID-19 infection can affect the cardiovascular system including the heart muscle. Myocardial strain measures the function of the heart muscle at cell level and can pick up unusual heart function before routine measurements. Ejection fraction (how hard the heart muscle is squeezing) can be seen with our own eyes, but strain cannot and needs special techniques to see it. In this study we wanted to find out what was the strain on COVID-19 patients and if there was a relationship between strain and the outcome of the patients (if they were able to recover from COVID-19). The important finding of our study is that strain was low in all patients with COVID-19 infection regardless of routine measurements when compared with patients without the infection. However, in this study we found no correlation between the low strain and the result of the infection for the COVID-19 patients.

Keywords:

• coronavirus
• COVID-19 infection
• myocardial strain imaging
• speckle tracking echocardiography
• transthoracic echocardiography

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.