.: ORİJİNAL ARAŞTIRMA
Two Dimensional Speckle Tracking Echocardiographic Evaluation of Left Ventricle in Post-COVID-19 Patients with or without Cardiac Symptoms: A Retrospective Clinical Study
COVID-19 Enfeksiyonu Sonrasında Kardiyak Semptomu Olan ve Olmayan Hastalarda İki Boyutlu Speckle Tracking Ekokardiyografi ile Sol Ventrikül Fonksiyonlarının Değerlendirilmesi: Retrospektif Klinik Çalışma
Turkiye Klinikleri J Cardiovasc Sci. 2023;35(3):89-95
doi: 10.5336/cardiosci.2023-99075
Makale Dili: EN
Tam Metin
Ücretsiz Erişim
ABSTRACT
Objective: In recent years, coronavirus disease-2019 (COVID-19) has been the primary health problem and because of the virus affinity to endothelial cells, it has become an important reason of vascular problems and cardiac injury. After mild COVID-19 infection, patients frequently attend cardiology clinics with cardiac symptoms and their primary cardiac tests are mostly normal. In this study we aimed to analyze if two-dimensional speckle tracking echocardiography shows any difference between symptomatic and asymptomatic post-COVID19 patients when transthoracic echocardiography parameters are normal. Material and Methods: In this retrospective single center study, 2,741 transthoracic echocardiography records were assessed and 108 post-COVID-19 patients were detected and divided into symptomatic and asymptomatic patient groups and left ventricular global longitudinal strain (LV-GLS) values were compared. Results: The number of patients with normal LV-GLS values were equal in the groups and there were 4 patients whose values were borderline in the asymptomatic group, while there was none in the symptomatic group. The number of patients with impaired GLS values in the symptomatic group were higher than the asymptomatic group (15 vs 4 patients) and the difference was statistically different (p=0.008). The average LV-GLS values were -18.88±2.50 in the asymptomatic group and -17.40±3.68 in symptomatic group but the difference was not statistically significant (p=0.098). Conclusion: More symptomatic patients than the asymptomatic ones have impaired LV-GLS values according to the results of this study. Even if it is not statistically significant, the mean LV-GLS values are also reduced in symptomatic patients after mild COVID-19 infection.
Keywords: Echocardiography; speckle tracking echocardiography; global longitudinal strain; COVID-19; post-COVID-19
Objective: In recent years, coronavirus disease-2019 (COVID-19) has been the primary health problem and because of the virus affinity to endothelial cells, it has become an important reason of vascular problems and cardiac injury. After mild COVID-19 infection, patients frequently attend cardiology clinics with cardiac symptoms and their primary cardiac tests are mostly normal. In this study we aimed to analyze if two-dimensional speckle tracking echocardiography shows any difference between symptomatic and asymptomatic post-COVID19 patients when transthoracic echocardiography parameters are normal. Material and Methods: In this retrospective single center study, 2,741 transthoracic echocardiography records were assessed and 108 post-COVID-19 patients were detected and divided into symptomatic and asymptomatic patient groups and left ventricular global longitudinal strain (LV-GLS) values were compared. Results: The number of patients with normal LV-GLS values were equal in the groups and there were 4 patients whose values were borderline in the asymptomatic group, while there was none in the symptomatic group. The number of patients with impaired GLS values in the symptomatic group were higher than the asymptomatic group (15 vs 4 patients) and the difference was statistically different (p=0.008). The average LV-GLS values were -18.88±2.50 in the asymptomatic group and -17.40±3.68 in symptomatic group but the difference was not statistically significant (p=0.098). Conclusion: More symptomatic patients than the asymptomatic ones have impaired LV-GLS values according to the results of this study. Even if it is not statistically significant, the mean LV-GLS values are also reduced in symptomatic patients after mild COVID-19 infection.
Keywords: Echocardiography; speckle tracking echocardiography; global longitudinal strain; COVID-19; post-COVID-19
ÖZET
Amaç: Son yıllarda, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] öncelikli bir sağlık sorunu olup, virüsün endotel hücrelerine olan afinitesi nedeniyle vasküler problemler ve kardiyak hasar açısından önemli bir sebep hâline gelmiştir. Hafif geçirilen COVID-19 enfeksiyonu sonrasında, hastalar kardiyoloji kliniklerine kardiyak şikâyetlerle başvurmakta ve primer kardiyak testleri çoğunlukla normal bulunmaktadır. Bu çalışmada, iki boyutlu speckle tracking ekokardiyografi kullanılarak, normal ekokardiyografik parametreleri olan semptomatik ve asemptomatik hastalar arasında fark olup olmadığının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu tek merkezli retrospektif çalışmada, 2.741 transtorasik ekokardiyografi kaydı incelenmiş olup, içlerinden 108 COVID-19 sonrası hasta seçilmiştir. Bu hastalar semptomatik ve asemptomatik olarak ikiye ayrılarak, sol ventrikül global longitudinal strain sonuçları [left ventricular global longitudinal strain values (LV-GLS)] kıyaslanmıştır. Bulgular: Her iki grupta normal LV-GLS olan hasta sayısı eşit olup, asemptomatik grupta 4 adet sınırda sonucu olan hasta izlenmekteydi. Semptomatik hasta grubunda GLS değeri bozulmuş olan hasta sayısı asemptomatik hasta grubundan anlamlı olarak fazla (15-4 hasta) bulundu (p=0,008). Ortalama GLS değeri asemptomatik grupta - 18,88±2,50 ve semptomatik grupta -17,40±3,68 olarak hesaplandı ancak aradaki fark istatistiksel olarak anlamlı bulunmadı (p=0,098). Sonuç: Çalışmamızın sonucunda daha fazla semptomatik hastada bozulmuş GLS değerlerine ulaşılmıştır. İstatistiksel olarak anlamlı olmasa bile, ortalama LV-GLS değerleri de COVID-19 enfeksiyonu sonrasında semptomatik olan hastalarda azalmıştır.
Anahtar Kelimeler: Ekokardiyografi; speckle tracking ekokardiyografi; global longitudinal strain; COVID-19; post-COVID-19
Amaç: Son yıllarda, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] öncelikli bir sağlık sorunu olup, virüsün endotel hücrelerine olan afinitesi nedeniyle vasküler problemler ve kardiyak hasar açısından önemli bir sebep hâline gelmiştir. Hafif geçirilen COVID-19 enfeksiyonu sonrasında, hastalar kardiyoloji kliniklerine kardiyak şikâyetlerle başvurmakta ve primer kardiyak testleri çoğunlukla normal bulunmaktadır. Bu çalışmada, iki boyutlu speckle tracking ekokardiyografi kullanılarak, normal ekokardiyografik parametreleri olan semptomatik ve asemptomatik hastalar arasında fark olup olmadığının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu tek merkezli retrospektif çalışmada, 2.741 transtorasik ekokardiyografi kaydı incelenmiş olup, içlerinden 108 COVID-19 sonrası hasta seçilmiştir. Bu hastalar semptomatik ve asemptomatik olarak ikiye ayrılarak, sol ventrikül global longitudinal strain sonuçları [left ventricular global longitudinal strain values (LV-GLS)] kıyaslanmıştır. Bulgular: Her iki grupta normal LV-GLS olan hasta sayısı eşit olup, asemptomatik grupta 4 adet sınırda sonucu olan hasta izlenmekteydi. Semptomatik hasta grubunda GLS değeri bozulmuş olan hasta sayısı asemptomatik hasta grubundan anlamlı olarak fazla (15-4 hasta) bulundu (p=0,008). Ortalama GLS değeri asemptomatik grupta - 18,88±2,50 ve semptomatik grupta -17,40±3,68 olarak hesaplandı ancak aradaki fark istatistiksel olarak anlamlı bulunmadı (p=0,098). Sonuç: Çalışmamızın sonucunda daha fazla semptomatik hastada bozulmuş GLS değerlerine ulaşılmıştır. İstatistiksel olarak anlamlı olmasa bile, ortalama LV-GLS değerleri de COVID-19 enfeksiyonu sonrasında semptomatik olan hastalarda azalmıştır.
Anahtar Kelimeler: Ekokardiyografi; speckle tracking ekokardiyografi; global longitudinal strain; COVID-19; post-COVID-19
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