J Cardiovasc Imaging.  2023 Jul;31(3):125-132. 10.4250/jcvi.2022.0120.

Cardiac Phenotyping of SARS-CoV-2 in British Columbia: A Prospective Echo Study With Strain Imaging

• Yim J
• Tsang MY
• Venkataraman A
• Balthazaar S
• Gin K
• Jue J
• Nair P
• Luong C
• Yeung DF
• Moss R
• Virani SA
• McKay J
• Williams M
• Sayre EC
• Abolmaesumi P
• Tsang TS

• KMID: 2544963
• DOI: http://doi.org/10.4250/jcvi.2022.0120

Abstract

BACKGROUND
There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients.
METHODS
All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul’s Hospital. At 4–18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson’s, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec).
RESULTS
A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients.
CONCLUSIONS
Most post-COVID patients had normal LVEF at 4–18 weeks post diagnosis, but over half had abnormal LV GLS.

Keyword

COVID-19; SARS-CoV-2; Echocardiography; Strain imaging; Speckle tracking echocardiography