Evaluation of left ventricular global functions with speckle tracking echocardiography in patients recovered from COVID-19

Ozer S., CANDAN L., Ozyildiz A. G., TURAN O. E.

INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, vol.37, no.7, pp.2227-2233, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37 Issue: 7
  • Publication Date: 2021
  • Doi Number: 10.1007/s10554-021-02211-5
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, EMBASE
  • Page Numbers: pp.2227-2233
  • Keywords: Coronavirus, COVID-19 infection, Left ventricular global longitudinal strain, Transthoracic echocardiography, HEART-FAILURE, STRAIN
  • Recep Tayyip Erdoğan University Affiliated: Yes


Highly sensitive troponin (hs-TnI) levels are frequently elevated in COVID-19 patients and are associated with increased cardiovascular mortality during hospitalization. However, no data exists on cardiac involvement in patients recovered from COVID-19 infection. We aimed to evaluate by global longitudinal strain (LV-GLS) whether there is subclinical myocardial deformation after COVID-19 infection. Two-dimensional speckle tracking echocardiography (2D-STE) was performed within 29.5 +/- 4.5 days after COVID-19 treatment. The standard GLS limit was identified at < -18%. The patients were divided into two groups according to their hs-TnI levels during hospitalization as with (> 11.6 ng/dl) and without (< 11.6 ng/dl) myocardial injury. Patients' (n = 74) mean age was 59.9 years, and women were in the majority (60.8%). Of the patients, 43.2% of them were hypertensive, and 10.9% were diabetic. Abnormal LV-GLS values (> -18) were measured in 28 patients (37.8%). While 16 (57.1%) of these patients were in the group with myocardial injury, 12 (26.1%) of them were in the group without myocardial injury (p = 0.014). D-dimer, C reactive protein, white blood cell levels were higher in the group with myocardial injury (All p values < 0.05). Electrocardiographically, 9 (12.2%) patients had T wave inversion, while two patients had a bundle branch block. Subclinical left ventricular dysfunction was observed in approximately one-third of the patients at the one-month follow-up after COVID-19 infection. This rate was higher in those who develop myocardial injury during hospitalization. This result suggests that patients recovered from COVID-19 infection should be evaluated and followed in terms of cardiac involvement.