Left and right ventricular dysfunction in patients with COVID-19-associated myocardial injury

被引:47
作者
Bieber, Stephanie [1 ,2 ]
Kraechan, Angelina [1 ,2 ]
Hellmuth, Johannes C. [2 ,3 ]
Muenchhoff, Maximilian [2 ,4 ,5 ,6 ]
Scherer, Clemens [1 ,2 ,8 ]
Schroeder, Ines [7 ]
Irlbeck, Michael [7 ]
Kaeaeb, Stefan [2 ,8 ]
Massberg, Steffen [1 ,8 ]
Hausleiter, Joerg [1 ,8 ]
Grabmaier, Ulrich [1 ,2 ,8 ]
Orban, Mathias [1 ,8 ]
Weckbach, Ludwig T. [1 ,2 ,8 ,9 ]
机构
[1] Ludwig Maximilians Univ Munchen, Klinikum Univ Muenchen, Med Klin & Poliklin 1, Marchioninistr 15, D-81377 Munich, Germany
[2] Ludwig Maximilians Univ Munchen, COVID Registry LMU Munich CORKUM 19, Univ Hosp, Munich, Germany
[3] Ludwig Maximilians Univ Munchen, Klinikum Univ Muenchen, Med Klin & Poliklin 3, Munich, Germany
[4] LMU Muenchen, Max Von Pettenkofer Inst, Natl Reference Ctr Retroviruses, Fac Med, Munich, Germany
[5] LMU Muenchen, Gene Ctr, Natl Reference Ctr Retroviruses, Fac Med,Virol, Munich, Germany
[6] DZIF German Ctr Infect Res, Partner Site, Munich, Germany
[7] Ludwig Maximilians Univ Munchen, Dept Anaesthesiol, Munich, Germany
[8] DZHK German Ctr Cardiovasc Res, Partner Site, Munich, Germany
[9] Ludwig Maximilians Univ Munchen, Inst Cardiovasc Physiol & Pathophysiol, Biomed Ctr, Planegg Martinsried, Germany
关键词
COVID-19; Myocardial injury; Heart failure; Three-dimensional echocardiography; Global longitudinal strain; CARDIAC CHAMBER QUANTIFICATION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; DIASTOLIC FUNCTION; ECHOCARDIOGRAPHY; RECOMMENDATIONS; UPDATE; ADULTS;
D O I
10.1007/s15010-020-01572-8
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Purpose SARS-COV-2 infection can develop into a multi-organ disease. Although pathophysiological mechanisms of COVID-19-associated myocardial injury have been studied throughout the pandemic course in 2019, its morphological characterisation is still unclear. With this study, we aimed to characterise echocardiographic patterns of ventricular function in patients with COVID-19-associated myocardial injury. Methods We prospectively assessed 32 patients hospitalised with COVID-19 and presence or absence of elevated high sensitive troponin T (hsTNT+ vs. hsTNT-) by comprehensive three-dimensional (3D) and strain echocardiography. Results A minority (34.3%) of patients had normal ventricular function, whereas 65.7% had left and/or right ventricular dysfunction defined by impaired left and/or right ventricular ejection fraction and strain measurements. Concomitant biventricular dysfunction was common in hsTNT+ patients. We observed impaired left ventricular (LV) global longitudinal strain (GLS) in patients with myocardial injury (-13.9% vs. -17.7% for hsTNT+ vs. hsTNT-, p = 0.005) but preserved LV ejection fraction (52% vs. 59%, p = 0.074). Further, in these patients, right ventricular (RV) systolic function was impaired with lower RV ejection fraction (40% vs. 49%, p = 0.001) and reduced RV free wall strain (-18.5% vs. -28.3%, p = 0.003). Myocardial dysfunction partially recovered in hsTNT + patients after 52 days of follow-up. In particular, LV-GLS and RV-FWS significantly improved from baseline to follow-up (LV-GLS: -13.9% to -16.5%, p = 0.013; RV-FWS: -18.5% to -22.3%, p = 0.037). Conclusion In patients with COVID-19-associated myocardial injury, comprehensive 3D and strain echocardiography revealed LV dysfunction by GLS and RV dysfunction, which partially resolved at 2-month follow-up.
引用
收藏
页码:491 / 500
页数:10
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