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Left and right ventricular dysfunction in patients with COVID-19-associated myocardial injury.
Bieber, Stéphanie; Kraechan, Angelina; Hellmuth, Johannes C; Muenchhoff, Maximilian; Scherer, Clemens; Schroeder, Ines; Irlbeck, Michael; Kaeaeb, Stefan; Massberg, Steffen; Hausleiter, Joerg; Grabmaier, Ulrich; Orban, Mathias; Weckbach, Ludwig T.
  • Bieber S; Medizinische Klinik und Poliklinik I, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany. Stephanie.Bieber@med.uni-muenchen.de.
  • Kraechan A; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany. Stephanie.Bieber@med.uni-muenchen.de.
  • Hellmuth JC; Medizinische Klinik und Poliklinik I, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany.
  • Muenchhoff M; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Scherer C; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Schroeder I; Medizinische Klinik und Poliklinik III, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-University, Munich, Germany.
  • Irlbeck M; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Kaeaeb S; Max Von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, Faculty of Medicine, LMU Muenchen, Munich, Germany.
  • Massberg S; DZIF (German Center for Infection Research), Partner Site, Munich, Germany.
  • Hausleiter J; Medizinische Klinik und Poliklinik I, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-University, Marchioninistraße 15, 81377, Munich, Germany.
  • Grabmaier U; COVID-19 Registry of the LMU Munich (CORKUM), University Hospital, LMU Munich, Munich, Germany.
  • Orban M; DZHK (German Centre for Cardiovascular Research), Partner Site, Munich, Germany.
  • Weckbach LT; Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany.
Infection ; 49(3): 491-500, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1053123
Semantic information from SemMedBD (by NLM)
1. myocardial injury PROCESS_OF Patients
Subject
myocardial injury
Predicate
PROCESS_OF
Object
Patients
2. Right Ventricular Dysfunction PROCESS_OF Patients
Subject
Right Ventricular Dysfunction
Predicate
PROCESS_OF
Object
Patients
3. Organ LOCATION_OF Disease
Subject
Organ
Predicate
LOCATION_OF
Object
Disease
4. Ventricular Function PROCESS_OF Patients
Subject
Ventricular Function
Predicate
PROCESS_OF
Object
Patients
5. Heart Ventricle LOCATION_OF Normal function
Subject
Heart Ventricle
Predicate
LOCATION_OF
Object
Normal function
6. Normal function PROCESS_OF Patients
Subject
Normal function
Predicate
PROCESS_OF
Object
Patients
7. Myocardial dysfunction PROCESS_OF Patients
Subject
Myocardial dysfunction
Predicate
PROCESS_OF
Object
Patients
8. myocardial injury PROCESS_OF Patients
Subject
myocardial injury
Predicate
PROCESS_OF
Object
Patients
9. Right Ventricular Dysfunction PROCESS_OF Patients
Subject
Right Ventricular Dysfunction
Predicate
PROCESS_OF
Object
Patients
10. Organ LOCATION_OF Disease
Subject
Organ
Predicate
LOCATION_OF
Object
Disease
11. Ventricular Function PROCESS_OF Patients
Subject
Ventricular Function
Predicate
PROCESS_OF
Object
Patients
12. Heart Ventricle LOCATION_OF Normal function
Subject
Heart Ventricle
Predicate
LOCATION_OF
Object
Normal function
13. Normal function PROCESS_OF Patients
Subject
Normal function
Predicate
PROCESS_OF
Object
Patients
14. Myocardial dysfunction PROCESS_OF Patients
Subject
Myocardial dysfunction
Predicate
PROCESS_OF
Object
Patients
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)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Infection Year: 2021 Document Type: Article Affiliation country: S15010-020-01572-8

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ventricular Dysfunction / COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Infection Year: 2021 Document Type: Article Affiliation country: S15010-020-01572-8