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.