Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity

Aims: Myocardial abnormalities are common during COVID-19 infection and recovery. We examined left (LV) and right (RV) ventricular longitudinal strain in patients who had recovered from COVID-19 and assessed the correlation with exercise capacity. Methods and results: One hundred and eighty-four con...

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Autores principales:	Or Shimoni, Roman Korenfeld, Sorel Goland, Valery Meledin, Dan Haberman, Jacob George, Sara Shimoni
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	myocardial strain prolong COVID-19 exercise capacity Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/cc4a886feab44f80b72388c7d1bd73cb
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spelling	oai:doaj.org-article:cc4a886feab44f80b72388c7d1bd73cb2021-11-25T16:47:56ZSubclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity10.3390/biology101112012079-7737https://doaj.org/article/cc4a886feab44f80b72388c7d1bd73cb2021-11-01T00:00:00Zhttps://www.mdpi.com/2079-7737/10/11/1201https://doaj.org/toc/2079-7737Aims: Myocardial abnormalities are common during COVID-19 infection and recovery. We examined left (LV) and right (RV) ventricular longitudinal strain in patients who had recovered from COVID-19 and assessed the correlation with exercise capacity. Methods and results: One hundred and eighty-four consecutive patients with history of COVID-19 disease who had been referred to rest or stress echocardiography because of symptoms, mainly dyspnea and chest pain, were included in the study. These patients were compared to 106 patients with similar age, symptoms, and risk factor profile with no history of COVID-19 disease. Clinical and echocardiographic parameters, including strain imaging, were assessed. The patient’s age was 48 ± 12 years. Twenty-two patients had undergone severe disease. There were no differences in the LV ejection fraction and diastolic function between the groups. However, LV and RV global and free wall strain were significantly lower (in absolute numbers) in patients who had recovered form COVID-19 infection (−20.41 ± 2.32 vs −19.39 ± 3.36, <i>p</i> = 0.001, −23.69 ± 3.44 vs −22.09 ± 4.20, <i>p</i> = 0.001 and −27.24 ± 4.7 vs −25.43 ± 4.93, <i>p</i> = 0.021, respectively). Global Longitudinal Strain (GLS) < −20% was present in only 37% of post COVID-19 patients. Sixty-four patients performed exercise echocardiography. Patients with GLS < −20% had higher exercise capacity with higher peak metabolic equivalent and exercise time compared to patients with GLS ≥ −20% (12.6 ± 2 vs 10 ± 2.5 METss and 8:00 ± 2:08 vs 6:24 ± 2:03 min, <i>p</i> < 0.001 and <i>p</i> = 0.003, respectively). Conclusion: In patients, who had recovered from COVID-19 infection, both LV and RV strain are significantly lower compared to control patients. The exercise capacity of these patients correlates with LV strain values. Rest and stress echocardiography in patients with symptoms after COVID-19 infection may identify patients that need further follow up to avoid long term complications of the disease. These preliminary results warrant further research, to test the natural history of these findings and the need and timing of treatment.Or ShimoniRoman KorenfeldSorel GolandValery MeledinDan HabermanJacob GeorgeSara ShimoniMDPI AGarticlemyocardial strainprolong COVID-19exercise capacityBiology (General)QH301-705.5ENBiology, Vol 10, Iss 1201, p 1201 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	myocardial strain prolong COVID-19 exercise capacity Biology (General) QH301-705.5
spellingShingle	myocardial strain prolong COVID-19 exercise capacity Biology (General) QH301-705.5 Or Shimoni Roman Korenfeld Sorel Goland Valery Meledin Dan Haberman Jacob George Sara Shimoni Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
description	Aims: Myocardial abnormalities are common during COVID-19 infection and recovery. We examined left (LV) and right (RV) ventricular longitudinal strain in patients who had recovered from COVID-19 and assessed the correlation with exercise capacity. Methods and results: One hundred and eighty-four consecutive patients with history of COVID-19 disease who had been referred to rest or stress echocardiography because of symptoms, mainly dyspnea and chest pain, were included in the study. These patients were compared to 106 patients with similar age, symptoms, and risk factor profile with no history of COVID-19 disease. Clinical and echocardiographic parameters, including strain imaging, were assessed. The patient’s age was 48 ± 12 years. Twenty-two patients had undergone severe disease. There were no differences in the LV ejection fraction and diastolic function between the groups. However, LV and RV global and free wall strain were significantly lower (in absolute numbers) in patients who had recovered form COVID-19 infection (−20.41 ± 2.32 vs −19.39 ± 3.36, <i>p</i> = 0.001, −23.69 ± 3.44 vs −22.09 ± 4.20, <i>p</i> = 0.001 and −27.24 ± 4.7 vs −25.43 ± 4.93, <i>p</i> = 0.021, respectively). Global Longitudinal Strain (GLS) < −20% was present in only 37% of post COVID-19 patients. Sixty-four patients performed exercise echocardiography. Patients with GLS < −20% had higher exercise capacity with higher peak metabolic equivalent and exercise time compared to patients with GLS ≥ −20% (12.6 ± 2 vs 10 ± 2.5 METss and 8:00 ± 2:08 vs 6:24 ± 2:03 min, <i>p</i> < 0.001 and <i>p</i> = 0.003, respectively). Conclusion: In patients, who had recovered from COVID-19 infection, both LV and RV strain are significantly lower compared to control patients. The exercise capacity of these patients correlates with LV strain values. Rest and stress echocardiography in patients with symptoms after COVID-19 infection may identify patients that need further follow up to avoid long term complications of the disease. These preliminary results warrant further research, to test the natural history of these findings and the need and timing of treatment.
format	article
author	Or Shimoni Roman Korenfeld Sorel Goland Valery Meledin Dan Haberman Jacob George Sara Shimoni
author_facet	Or Shimoni Roman Korenfeld Sorel Goland Valery Meledin Dan Haberman Jacob George Sara Shimoni
author_sort	Or Shimoni
title	Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
title_short	Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
title_full	Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
title_fullStr	Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
title_full_unstemmed	Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity
title_sort	subclinical myocardial dysfunction in patients recovered from covid-19 disease: correlation with exercise capacity
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/cc4a886feab44f80b72388c7d1bd73cb
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Subclinical Myocardial Dysfunction in Patients Recovered from COVID-19 Disease: Correlation with Exercise Capacity

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