TY - JOUR
T1 - Ventricular Changes in Patients with Acute COVID-19 Infection
T2 - Follow-up of the World Alliance Societies of Echocardiography (WASE-COVID) Study
AU - WASE-COVID Investigators
AU - Karagodin, Ilya
AU - Singulane, Cristiane Carvalho
AU - Descamps, Tine
AU - Woodward, Gary M.
AU - Xie, Mingxing
AU - Tucay, Edwin S.
AU - Sarwar, Rizwan
AU - Vasquez-Ortiz, Zuilma Y.
AU - Alizadehasl, Azin
AU - Monaghan, Mark J.
AU - Ordonez Salazar, Bayardo A.
AU - Soulat-Dufour, Laurie
AU - Mostafavi, Atoosa
AU - Moreo, Antonella
AU - Citro, Rodolfo
AU - Narang, Akhil
AU - Wu, Chun
AU - Addetia, Karima
AU - Tude Rodrigues, Ana C.
AU - Lang, Roberto M.
AU - Asch, Federico M.
AU - Munoz, Vince Ryan V.
AU - De Marchi, Rafael Porto
AU - Alday-Ramirez, Sergio M.
AU - Orihuela, Consuelo
AU - Sadeghpour, Anita
AU - Breeze, Jonathan
AU - Hoare, Amy
AU - Rosales, Carlos Ixcanparij
AU - Cohen, Ariel
AU - Milani, Martina
AU - Trolese, Ilaria
AU - Belli, Oriana
AU - De Chiara, Benedetta
AU - Bellino, Michele
AU - Iuliano, Giuseppe
AU - Yang, Yun
N1 - Funding Information:
This work was supported by the American Society of Echocardiography Foundation, the University of Chicago, and MedStar Health with in-kind support from Ultromics and TOMTEC. Conflicts of Interest: G.M.W., and T.D. are employees of Ultromics. R.S. is a consultant for Ultromics. M.J.M. is on the advisory board and speaker's bureau for Bracco and Philips. F.M.A. received institutional (MedStar Health) research grants from TOMTEC, Ultromics, GE, and Caption Health and is on the nonpaid scientific advisory committee for Ultromics. R.M.L. is on the advisory board and speaker's bureau for Philips and the advisory board for Caption Health. All other authors have no conflicts of interest to disclose related to this work.
Funding Information:
This work was supported by the American Society of Echocardiography Foundation , the University of Chicago , and MedStar Health with in-kind support from Ultromics and TOMTEC .
Publisher Copyright:
© 2021 American Society of Echocardiography
PY - 2022/3
Y1 - 2022/3
N2 - Background: COVID-19 infection is known to cause a wide array of clinical chronic sequelae, but little is known regarding the long-term cardiac complications. We aim to report echocardiographic follow-up findings and describe the changes in left (LV) and right ventricular (RV) function that occur following acute infection. Methods: Patients enrolled in the World Alliance Societies of Echocardiography-COVID study with acute COVID-19 infection were asked to return for a follow-up transthoracic echocardiogram. Overall, 198 returned at a mean of 129 days of follow-up, of which 153 had paired baseline and follow-up images that were analyzable, including LV volumes, ejection fraction (LVEF), and longitudinal strain (LVLS). Right-sided echocardiographic parameters included RV global longitudinal strain, RV free wall strain, and RV basal diameter. Paired echocardiographic parameters at baseline and follow-up were compared for the entire cohort and for subgroups based on the baseline LV and RV function. Results: For the entire cohort, echocardiographic markers of LV and RV function at follow-up were not significantly different from baseline (all P > .05). Patients with hyperdynamic LVEF at baseline (>70%), had a significant reduction of LVEF at follow-up (74.3% ± 3.1% vs 64.4% ± 8.1%, P < .001), while patients with reduced LVEF at baseline (<50%) had a significant increase (42.5% ± 5.9% vs 49.3% ± 13.4%, P = .02), and those with normal LVEF had no change. Patients with normal LVLS (<−18%) at baseline had a significant reduction of LVLS at follow-up (−21.6% ± 2.6% vs −20.3% ± 4.0%, P = .006), while patients with impaired LVLS at baseline had a significant improvement at follow-up (−14.5% ± 2.9% vs −16.7% ± 5.2%, P < .001). Patients with abnormal RV global longitudinal strain (>−20%) at baseline had significant improvement at follow-up (−15.2% ± 3.4% vs −17.4% ± 4.9%, P = .004). Patients with abnormal RV basal diameter (>4.5 cm) at baseline had significant improvement at follow-up (4.9 ± 0.7 cm vs 4.6 ± 0.6 cm, P = .019). Conclusions: Overall, there were no significant changes over time in the LV and RV function of patients recovering from COVID-19 infection. However, differences were observed according to baseline LV and RV function, which may reflect recovery from the acute myocardial injury occurring in the acutely ill. Left ventricular and RV function tends to improve in those with impaired baseline function, while it tends to decrease in those with hyperdynamic LV or normal RV function.
AB - Background: COVID-19 infection is known to cause a wide array of clinical chronic sequelae, but little is known regarding the long-term cardiac complications. We aim to report echocardiographic follow-up findings and describe the changes in left (LV) and right ventricular (RV) function that occur following acute infection. Methods: Patients enrolled in the World Alliance Societies of Echocardiography-COVID study with acute COVID-19 infection were asked to return for a follow-up transthoracic echocardiogram. Overall, 198 returned at a mean of 129 days of follow-up, of which 153 had paired baseline and follow-up images that were analyzable, including LV volumes, ejection fraction (LVEF), and longitudinal strain (LVLS). Right-sided echocardiographic parameters included RV global longitudinal strain, RV free wall strain, and RV basal diameter. Paired echocardiographic parameters at baseline and follow-up were compared for the entire cohort and for subgroups based on the baseline LV and RV function. Results: For the entire cohort, echocardiographic markers of LV and RV function at follow-up were not significantly different from baseline (all P > .05). Patients with hyperdynamic LVEF at baseline (>70%), had a significant reduction of LVEF at follow-up (74.3% ± 3.1% vs 64.4% ± 8.1%, P < .001), while patients with reduced LVEF at baseline (<50%) had a significant increase (42.5% ± 5.9% vs 49.3% ± 13.4%, P = .02), and those with normal LVEF had no change. Patients with normal LVLS (<−18%) at baseline had a significant reduction of LVLS at follow-up (−21.6% ± 2.6% vs −20.3% ± 4.0%, P = .006), while patients with impaired LVLS at baseline had a significant improvement at follow-up (−14.5% ± 2.9% vs −16.7% ± 5.2%, P < .001). Patients with abnormal RV global longitudinal strain (>−20%) at baseline had significant improvement at follow-up (−15.2% ± 3.4% vs −17.4% ± 4.9%, P = .004). Patients with abnormal RV basal diameter (>4.5 cm) at baseline had significant improvement at follow-up (4.9 ± 0.7 cm vs 4.6 ± 0.6 cm, P = .019). Conclusions: Overall, there were no significant changes over time in the LV and RV function of patients recovering from COVID-19 infection. However, differences were observed according to baseline LV and RV function, which may reflect recovery from the acute myocardial injury occurring in the acutely ill. Left ventricular and RV function tends to improve in those with impaired baseline function, while it tends to decrease in those with hyperdynamic LV or normal RV function.
KW - COVID-19
KW - Echocardiography
KW - Left ventricular function
KW - Right ventricular function
KW - WASE
UR - http://www.scopus.com/inward/record.url?scp=85120440042&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120440042&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2021.10.015
DO - 10.1016/j.echo.2021.10.015
M3 - Article
C2 - 34752928
AN - SCOPUS:85120440042
SN - 0894-7317
VL - 35
SP - 295
EP - 304
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 3
ER -