Myocardial performance index increases at long-term follow-up in patients with mild to moderate COVID-19.

ABSTRACT

BACKGROUND: The long-term cardiovascular effects of Coronavirus disease-2019 (COVID-19) are not yet well known. Myocardial performance index (MPI) is a non-invasive, inexpensive and reproducible echocardiographic parameter that reflects systolic and diastolic cardiac functions. The aim of the study was to compare MPI with a healthy control group in patients with mild or moderate COVID-19 infection who subsequently had unexplained cardiac symptoms. METHODS: The study included 200 patients aged 18-70 years who were diagnosed with COVID-19 infection at least 2 months ago and defined cardiac symptoms in their follow-up. Patients with mild or moderate symptoms, no history of hospitalization, and no other pathology that could explain cardiac symptoms were included in the study. As the control group, 182 healthy volunteers without COVID-19 were evaluated. Echocardiographic examination was performed on the entire study group. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT), and ejection time (ET) were measured by tissue Doppler imaging. MPI was calculated with the IVCT+IVRT/ET formula. RESULTS: The mean age of the study group was 44.24 ± 13.49 years. In the patient group the MPI was significantly higher (.50 ± .11 vs .46 ± .07, p < .001), IVRT was longer (69.67 ± 15.43 vs 65.94 ± 12.03 ms, p = . 008), and ET was shorter (271.09 ± 36.61 vs 271.09 ± 36.61 ms, p = .028). IVCT was similar between groups (63.87 ± 13.66 vs. 63.21 ± 10.77 ms, p = .66). Mitral E and mitral A wave, E', A', and E/A were similar in both groups. CONCLUSIONS: Our study showed that conventional diastolic function parameters were not affected in patients who survived COVID-19 with mild symptoms but had symptoms in the long term. However, MPI measurements showed left ventricular dysfunction. To our knowledge, this is the first echocardiographic follow-up study to evaluate left ventricular systolic and diastolic functions with MPI in COVID-19 patients. We think that when cardiac involvement assessment is required in patients who have survived COVID-19, MPI should be measured alongside other echocardiographic measurements.