Echocardiographic features of COVID-19 patients without significant baseline cardiovascular disease

Authors: Yakovlev S.A., Dukhin O.A., Kalinskaya A.I., Ryzhkova E.V., Andreeva E.V., Lebedeva A.Yu., Vasilieva E.Yu., Shpektor A.V.

Company: 1 Davydovskiy City Clinical Hospital of Moscow Department of Health, Moscow, Russian Federation
2 Department of Cardiology of Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of Ministry of Health of the Russian Federation, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2021-15-3-367-376

For citation: Yakovlev S.A., Dukhin O.A., Kalinskaya A.I., Ryzhkova E.V., Andreeva E.V., Lebedeva A.Yu., Vasilieva E.Yu., Shpektor A.V. Echocardiographic features of COVID-19 patients without significant baseline cardiovascular disease. Creative Cardiology. 2021; 15 (3): 367–76 (in Russ.). DOI: 10.24022/1997-3187-2021-15-3-367-376

Received / Accepted:  28.07.2021 / 25.08.2021

Keywords: COVID-19 echocardiography global longitudinal strain

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Abstract

Objective. To assess the relationship between the severity of COVID-19 in patients without significant baseline cardiovascular pathology and various echocardiographic parameters of myocardial dysfunction.

Material and methods. 46 patients with COVID-19 were included in our study: 33 patients of moderate severity and 13 – with severe disease. On days 1 and 9 upon admission, all patients underwent an echocardiographic study with standard assessment of the both ventricles function, as well as an assessment of their global longitudinal strain (GLS). Comparison of the studied parameters was carried out both between groups of patients and within each group in dynamics.

Results. On day 1patients in the severe group had higher values of the systolic gradient on the tricuspid valve (22.0 [21.0; 26.0] vs 30.0 [24.0; 34.5] mm Hg, p = 0.02), systolic excursion of the plane of the tricuspid ring (2.3 [2.1; 2.4] vs 2.0 [1.9; 2.2] mm, p = 0.016), E/e' ratio (9.5 [7.7; 8.9] vs 7.5 [6.8; 9.3], p = 0.03). At day 9 among patients in the severe group, there was a decrease in end-diastolic (111.0 [100.0; 120.0] vs 100.0 [89.0; 105.0] ml, p = 0.03) and of end-systolic (35.5 [32.0; 41, 2] vs 28.0 [25.0; 31.8] ml, p < 0.01) volumes of the left ventricle. There was a decrease in GLS of the both ventricles compared to general accepted values. In dynamics, there was an increase in the GLS of the right ventricle in both groups, but it was more pronounced among severe group of patients (day 1 –18.5 [–15.2; –21.1] vs –20.2 [–15.8.1; –21.1] %, p = 0.03). The troponin levels were in the normal range.

Conclusion. In COVID-19 patients without significant baseline cardiovascular pathology, there is a transient decrease in longitudinal strain of both ventricles, even in the absence of clinical and laboratory signs of acute myocardial injury.

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About Authors

  • Sergey A. Yakovlev, Ultrasonic Diagnostics Physician; ORCID
  • Oleg A. Dukhin, Postgraduate; ORCID
  • Anna I. Kalinskaya, Associate Professor, Cand. Med. Sci., Head of Department; ORCID
  • Evgeniya V. Ryzhkova, Ultrasonic Diagnostics Physician; ORCID
  • El’za V. Andreeva, Ultrasonic Diagnostics Physician; ORCID
  • Anastasiya Yu. Lebedeva, Dr. Med. Sci., Professor, Deputy Chief Physician; ORCID
  • Elena Yu. Vasilieva, Dr. Med. Sci., Professor, Head of Laboratory, Chief Physician; ORCID
  • Aleksander V. Shpektor, Dr. Med. Sci., Professor, Corresponding Member of RAS, Chief of Chair, Head of the University Clinic of Cardiology; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery