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1.
Infection ; 49(3): 491-500, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1053123

ABSTRACT

PURPOSE: SARS-COV-2 infection can develop into a multi-organ disease. Although pathophysiological mechanisms of COVID-19-associated myocardial injury have been studied throughout the pandemic course in 2019, its morphological characterisation is still unclear. With this study, we aimed to characterise echocardiographic patterns of ventricular function in patients with COVID-19-associated myocardial injury. METHODS: We prospectively assessed 32 patients hospitalised with COVID-19 and presence or absence of elevated high sensitive troponin T (hsTNT+ vs. hsTNT-) by comprehensive three-dimensional (3D) and strain echocardiography. RESULTS: A minority (34.3%) of patients had normal ventricular function, whereas 65.7% had left and/or right ventricular dysfunction defined by impaired left and/or right ventricular ejection fraction and strain measurements. Concomitant biventricular dysfunction was common in hsTNT+ patients. We observed impaired left ventricular (LV) global longitudinal strain (GLS) in patients with myocardial injury (-13.9% vs. -17.7% for hsTNT+ vs. hsTNT-, p = 0.005) but preserved LV ejection fraction (52% vs. 59%, p = 0.074). Further, in these patients, right ventricular (RV) systolic function was impaired with lower RV ejection fraction (40% vs. 49%, p = 0.001) and reduced RV free wall strain (-18.5% vs. -28.3%, p = 0.003). Myocardial dysfunction partially recovered in hsTNT + patients after 52 days of follow-up. In particular, LV-GLS and RV-FWS significantly improved from baseline to follow-up (LV-GLS: -13.9% to -16.5%, p = 0.013; RV-FWS: -18.5% to -22.3%, p = 0.037). CONCLUSION: In patients with COVID-19-associated myocardial injury, comprehensive 3D and strain echocardiography revealed LV dysfunction by GLS and RV dysfunction, which partially resolved at 2-month follow-up. TRIAL REGISTRATION: COVID-19 Registry of the LMU University Hospital Munich (CORKUM), WHO trial ID DRKS00021225.


Subject(s)
COVID-19/physiopathology , Ventricular Dysfunction/physiopathology , Aged , COVID-19/complications , COVID-19/diagnostic imaging , COVID-19/pathology , Echocardiography, Three-Dimensional , Female , Follow-Up Studies , Heart Ventricles/diagnostic imaging , Heart Ventricles/pathology , Heart Ventricles/physiopathology , Hospitalization , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , Stroke Volume , Troponin T/blood , Ventricular Dysfunction/diagnostic imaging , Ventricular Dysfunction/etiology , Ventricular Dysfunction/pathology
3.
Arq. bras. cardiol ; 114(5): 805-816, maio 2020. tab, graf
Article in Portuguese | LILACS (Americas) | ID: covidwho-910581

ABSTRACT

Resumo Frente à pandemia da doença causada pelo novo coronavírus (COVID-19), o manejo do paciente com fator de risco e/ou doença cardiovascular é desafiador nos dias de hoje. As complicações cardiovasculares evidenciadas nos pacientes com COVID-19 resultam de vários mecanismos, que vão desde lesão direta pelo vírus até complicações secundárias à resposta inflamatória e trombótica desencadeada pela infecção. O cuidado adequado do paciente com COVID-19 exige atenção ao sistema cardiovascular em busca de melhores desfechos.


Abstract In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.


Subject(s)
Humans , Pneumonia, Viral/complications , Cardiovascular Diseases/virology , Health Personnel/standards , Coronavirus Infections/complications , Betacoronavirus , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/therapy , Cardiovascular Physiological Phenomena , Risk Factors , Cardiopulmonary Resuscitation/standards , Practice Guidelines as Topic , Coronavirus Infections , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Ventricular Dysfunction/etiology , Pandemics , Patient Care/standards , Heart/physiopathology
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