Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography

ABSTRACT

Background and Aim: A new infectious outbreak sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now spreading all around the world. The aim of this study was to evaluate the prognostic value of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) in patients with coronavirus disease 2019 (COVID-19). Methods: In this prospective, single-center study, data were gathered from patients treated for COVID-19 between April 15 and April 30, 2020. Two-dimensional echocardiography (2-DE) and speckle tracking echocardiography (STE) images were obtained for all patients. Patients were divided into three groups those with severe COVID-19 infection, those with non-severe COVID-19 infection, and those without COVID-19 infection (the control group). Data regarding clinical characteristics and laboratory findings were obtained from electronic medical records. The primary endpoint was in-hospital mortality. Results: A total of 100 patients hospitalized for COVID-19 were included in this study. The mean age of the severe group (n=44) was 59.1±12.9, 40% of whom were male. The mean age of the non-severe group (n=56) was 53.7±15.1, 58% of whom were male. Of these patients, 22 died in the hospital. In patients in the severe group, LV-GLS and RV-LS were decreased compared to patients in the non-severe and control groups (LVGLS -14.5±1.8 vs. -16.7±1.3 vs. -19.4±1.6, respectively [p<0.001];RV-LS -17.2±2.3 vs. -20.5±3.2 vs. -27.3±3.1, respectively [p<0.001]). The presence of cardiac injury, D-dimer, arterial oxygen saturation (SaO2), LV-GLS (OR1.63, 95% confidence interval [CI] 1.08-2.47;p=0.010) and RV-LS (OR1.55, 95% CI 1.07-2.25;p=0.019) were identified as independent predictors of mortality via multivariate analysis. Conclusions: LV-GLS and RV-LS are independent predictors of in-hospital mortality in patients with COVID-19.