ABSTRACT
Objective: COVID-19 patients with cardiovascular involvement have been shown to have a worse prognosis compared to those without cardiovascular compromise. This study aimed to investigate whether left ventricular (LV) global and regional strain is impaired in patients with COVID-19 with or without pneumonia after discharge. Materials and Methods: Seventy-eight consecutive COVID-19 patients diagnosed by PCR test were enrolled in this cross-sectional study during their first follow-up visit to an outpatient clinic. All patients underwent two-dimensional echocardiography and speckle tracking echocardiography (STE) at the first follow-up visit. The patients were divided into two groups with or without pneumonia, and they were compared with the healthy control group. Results: A total of 123 subjects were included in the study (78 with COVID-19 and 45 in the control group). Admission and follow-up hs-troponin-T concentrations were similar in both the control group and patients with varying severity of COVID-19. LV ejection fraction (EF) was similar in all groups. However, LV global longitudinal strain (GLS) was significantly lower in subjects with pneumonia compared to the control group and subjects without pneumonia. Regional strain analysis showed that subjects with pneumonia had significantly lower strain values at mid-anterior, mid-anteroseptal, apical-inferior, apical-lateral, and apex regions than subjects without pneumonia or the control group. Conclusion: LV GLS and the regional strain were significantly impaired in COVID-19 patients with pneumonia compared to those without pneumonia or in to control group. This finding indicates that COVID-19 subjects with pneumonia should undergo strain measurement to detect concealed LV involvement. © 2023 The authors.
ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) has had a great impact on patients' physical problems as well as psychological status. However, there is limited data about the impact of psychological problems on cardiac function during the COVID-19 pandemic. In this study, we aimed to investigate the relationship between mental health disorders and subclinical early myocardial systolic dysfunction by left ventricular global longitudinal strain (LVGLS) imaging in patients recovered from COVID-19.Methods: Of the 108 participants, 71 patients had recovered from COVID-19;the members of the study group were prospectively recruited to the study after COVID-19 recovery. Comparisons were made with a risk-factor matched control group (n=37). The psychological status of the subjects, namely, Depression, Anxiety and Stress Scale-21 (DASS-21), and the Impact of Events Scale (IES-R) at follow-up visits, were assessed via questionnaire forms. The relationship between the psychological parameters and LVGLS values was subsequently evaluated.Results: Overall, 45.0% of patients with COVID-19 had some degree of anxiety after recovery. A significant negative correlation was found between LVGLS and DASS-21 total score, DASS-21 anxiety subscale score, IES-R total score, and IES-R intrusion subscale score (r=-0.251, p=0.02;r=-0.285, p=0.008;r=-0.291, p=0.007;and r=-0.367, p=0.001, respectively). Furthermore, the DASS-21 total score was identified as an independent predictor of LVGLS (b=-0.186, p=0.03).Conclusions: Patients who suffered from the COVID-19 disease may have experienced psychological distress symptoms due to COVID-19, which may be associated with silent impairment in myocardial systolic functions measured by global longitudinal strain analysis.
ABSTRACT
Purpose: The effects of different COVID-19 therapeutic strategies on cardiac function are uncertain. Therefore, this study aimed to evaluate the effects of different medical treatments on biventricular function in patients who had recovered from COVID-19. Materials and Methods: Speckle-tracking echocardiography was performed to examine the biventricular myocardial function of patients at follow-up visits after recovery from COVID-19. The patients were divided into two groups based on the medication they used during the active disease: favipiravir (FAV;n = 60) or hydroxychloroquine (HCQ;n = 60). A comparison was made with risk factor-matched controls (n = 41). Results: A total of 161 patients were included in the study. The left ventricular end-diastolic volume, end-systolic volume, end-diastolic diameter, and end-systolic diameter were higher in the HCQ and FAV groups compared to the controls, while the left ventricular ejection fraction was similar between all the groups. The right ventricular diameter was increased, and the systolic pulmonary artery pressure was higher in the HCQ and FAV groups compared to the controls. The left ventricular global longitudinal strain (-18 +/- 6.6 vs. -19.7 +/- 4.4 vs. -20.4 +/- 5, respectively), the right ventricular global longitudinal strain (-19.8 +/- 7.5 vs. -22.2 +/- 6 vs. -23.4 +/- 6.2, respectively), and the right ventricular free wall strain (-16.9 +/- 3.6 vs. -18.2 +/- 2.4 vs. -19.6 +/- 4.7, respectively) were worse in the HCQ group compared to the FAV and control groups. Conclusion: This study found echocardiographic evidence of subclinical cardiac involvement in both the HCQ and FAV groups compared to the controls. However, HCQ treatment was associated with an increased risk of biventricular subclinical systolic dysfunction in COVID-19 survivors compared with FAV treatment.
ABSTRACT
Background and Aim: A novel coronavirus disease 2019 (COVID-19) which was declared a pandemic in March 2020, has spread rapidly around the world and it is still threatening global health. COVID-19 infection may exhibit several clinical manifestations varying from mild respiratory illness to severe pneumonia and acute respiratory distress syndrome (ARDS). Many studies have shown that inflammatory responses play a pivotal role in the severity and prognosis of COVID-19 disease. Galectin-3, a b-galactoside-binding lectin, is a new important player in the pathophysiological processes of inflammation and fibrosis. In this study, we aimed to investigate the relationship between serum Galectin-3 levels at admission and pneumonia severity and inflammatory parameters in COVID-19 patients. Method(s): A total of 68 patients with laboratory, clinical and radiological confirmed COVID-19 were prospectively recruited to the study. The study population was classified into 2 groups as those with severe pneumonia (n=48) and those with mild pneumonia (n=20) based on chest computed tomography images at admission. Ten milliliter of peripheral venous blood were drawn within 24 hours of admission to estimate serum Galectin-3 levels. Patients with chronic renal failure, other inflammatory or rheumatic diseases and/or malignancies, cardiovascular diseases and diabetes mellitus were excluded from the study. We evaluated the relationship between Galectin-3 levels, pneumonia severity and laboratory parameters in COVID-19 patients. Result(s): The demographic and clinical data and laboratory findings of the study population are presented in Table 1. The mean age of the study population was 61.68+/-14.4 years (45 male;23 female). The mean level of Galectin-3 was 29.67+/-16.7 ng/mL. Serum Galectin-3, lactate dehydrogenase (LDH), C-reactive protein (CRP), prohormone B-type natriuretic peptide (pro-BNP), troponin-T, D-dimer and procalcitonin levels, white blood cell (WBC) counts, neutrophil and lymphocyte counts and percentages were significantly different between the groups (Table 1). Serum Galectin-3 levels were found to be higher in severe pneumonia group (p=0.04). In patients with mild pneumonia;Galectin-3 was negatively correlated with neutrophil percentage (r =-0.483 p=0.031) but was positively correlated with lymphocyte percentage and lymphocyte counts (r=0.428, p=0.05;r=0.554, p=0.011, respectively) (Table 2A). However, Galectin-3 was negatively correlated with WBC counts, neutrophil counts and neutrophil percentage (r=-0.317 p=0.028;r=-0.379 p=0.008;r=-0.609 p<0.001, respectively) and positively correlated with lymphocyte percentage (r=0.307;p=0.034) in COVID-19 patients with severe pneumonia (Table 2B). Conclusion(s): In this study, we found a significant relationship between serum Galectin-3 levels and pneumonia severity in COVID-19 patients. Therefore, Galectin-3, a new biomarker of inflammation, may be useful as a prognostic factor in patients with COVID-19.
ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) has had a great impact on patients' physical problems as well as psychological status. However, there is limited data about the impact of psychological problems on cardiac function during the COVID-19 pandemic. In this study, we aimed to investigate the relationship between mental health disorders and subclinical early myocardial systolic dysfunction by left ventricular global longitudinal strain (LVGLS) imaging in patients recovered from COVID-19. Method(s): Of the 108 participants, 71 patients had recovered from COVID-19;the members of the study group were prospectively recruited to the study after COVID-19 recovery. Comparisons were made with a risk-factor matched control group (n=37). The psychological status of the subjects, namely, Depression, Anxiety and Stress Scale-21 (DASS-21), and the Impact of Events Scale (IES-R) at follow-up visits, were assessed via questionnaire forms. The relationship between the psychological parameters and LVGLS values was subsequently evaluated. Result(s): Overall, 45.0% of patients with COVID-19 had some degree of anxiety after recovery. A significant negative correlation was found between LVGLS and DASS-21 total score, DASS-21 anxiety subscale score, IES-R total score, and IES-R intrusion subscale score (r= -0.251, p=0.02;r= -0.285, p=0.008;r= -0.291, p=0.007;and r= -0.367, p=0.001, respectively). Furthermore, the DASS-21 total score was identified as an independent predictor of LVGLS (beta= -0.186, p=0.03). Conclusion(s): Patients who suffered from the COVID-19 disease may have experienced psychological distress symptoms due to COVID-19, which may be associated with silent impairment in myocardial systolic functions measured by global longitudinal strain analysis. Copyright © 2022 Southern Society for Clinical Investigation