KEY WORDS
echocardiography, speckle tracking echocardiography, global longitudinal
strain, post-COVID
Introduction
In recent years, COVID-19 has been the primary health problem and
because of the virus affinity to endothelial cells, it has become an
important reason of vascular problems and cardiac injury. Acute
pericarditis, acute myocarditis and myocardial infarction are the main
clinical manifestations especially among patients treated in the
intensive care unit (1-4). Even though the potential pathogenesis of the
cardiac injury is not clear, the direct effect to ACE2 receptor and
hyperimmune response during sitokin storm are highly suspected (5-7) and
up to 7% of the COVID-related deaths have been attributed to
myocarditis (8).
After mild COVID-19 infection, patients frequently attend to the
cardiology clinics with cardiac symptoms like chest pain, shortness of
breath, palpitations, and reduced exercise capacity and their primary
cardiac tests are mostly normal. Because of the potential of possible
myocardial injury of the disease, simply applicable advanced techniques
like 2-D speckle tracking echocardiography (2D-STE), would be a better
method than conventional transthoracic echocardiography (TTE) for
evaluating regional and global myocardial deformation because it’s
independent of angle and can diagnose subclinical myocardial dysfunction
earlier (11-14).
The aim of the study is analysing if the difference of cardiac
deterioration could be shown with 2D-STE between symptomatic and
asymptomatic post-COVID patients when TTE parameters are normal.
Materials and Methods
In this retrospective single centre study, total of 2741 TTE records in
American Hospital’s Echocardiography laboratory between January
2021-August 2021 were assessed. Post-COVID patients (n:108) were
detected. The inclusion criteria of involvement to the study are having
had COVID-19 diagnosis by polymerase chain reaction (PCR) test
positiveness in the last 6 months and to be older than 18 years old.
Exclusion criteria were designated as; to be hospitalized because of
moderate or severe COVID-19 infection, having passed more than 6 months
after COVID-19 infection, severe valvular heart disease,
segmental/global left ventricular systolic disfunction, known coronary
artery disease, conduction disorder, rhythms other than normal sinus
rhythm and not having enough imaging frames of echocardiography for
calculating LV-GLS. After the exclusion criteria, 31 patients were
detected for ‘symptomatic group’ throughout total included 55 patients.
(Figure 1).
The study protocol was approved by the Local Ethics Committee as a
retrospective single centre study and was conducted according to the
Declaration of Helsinki.