Ventricular Changes in Patients with Acute COVID-19 Infection: Follow-up of the World Alliance Societies of Echocardiography (WASE-COVID) Study.

MedStar author(s):
Citation: Journal of the American Society of Echocardiography. 35(3):295-304, 2022 03.PMID: 34752928Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *COVID-19 | COVID-19/co [Complications] | Echocardiography/mt [Methods] | Follow-Up Studies | Heart Ventricles/dg [Diagnostic Imaging] | Humans | SARS-CoV-2 | Stroke Volume | Ventricular Function, Left | Ventricular Function, RightYear: 2022Local holdings: Available online through MWHC library: 2007 - presentISSN:
  • 0894-7317
Name of journal: Journal of the American Society of Echocardiography : official publication of the American Society of EchocardiographyAbstract: 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.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. Copyright (c) 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.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).All authors: Addetia K, Alizadehasl A, Asch FM, Citro R, Descamps T, Karagodin I, Lang RM, Monaghan MJ, Moreo A, Mostafavi A, Narang A, Ordonez Salazar BA, Sarwar R, Singulane CC, Soulat-Dufour L, Tucay ES, Tude Rodrigues AC, Vasquez-Ortiz ZY, WASE-COVID Investigators, Woodward GM, Wu C, Xie MOriginally published: Journal of the American Society of Echocardiography. 2021 Nov 06Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-01-25
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 34752928 Available 34752928

Available online through MWHC library: 2007 - present

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.

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. Copyright (c) 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

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).

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