Echocardiography helps guide treatment of recovering COVID-19 patients
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Imaging data can help clinicians detect signs of long-term cardiac complications in recovered COVID-19 patients, according to new research published in Echocardiography.
“With millions of people affected, it is essential to find the best follow-up protocol for COVID-19 infection,” wrote first author Leonardo Italia, MD, of the San Raffaele Scientific Institute in Italy, and colleagues. “The identification of patients with cardiac abnormalities is of pivotal importance as they may benefit from cardioprotective therapy and need different follow-up strategies.”
The group examined transthoracic echocardiographic (TTE) data from 123 recovered COVID-19 patients. All patients were originally hospitalized from March 3 to May 13, 2020, and patients were excluded if they presented with acute coronary syndrome, reduced kidney function, atrial fibrillation or a prior history of heart failure.
Overall, myocardial injury—defined as plasma levels of high sensitive troponin T (hsTnT) greater than 13.9 ng/L—was seen in 37.3% of patients. Patients with myocardial injury had a higher mean patient age (67.8 years old vs. 58.3 years old) and were more likely to also have hypertension, coronary artery disease or chronic obstructive pulmonary disease. They also faced a higher risk of being treated in the ICU.
After a median time of 85 days following hospitalization, patients were evaluated again. Patients who had originally showed signs of myocardial injury presented with “a significant reduction” in their mean left ventricle global longitudinal strain and were more likely to have impaired diastolic function or high values of pulmonary pressure.
“Subclinical myocardial injury during the acute phase of the infection has emerged as a relatively frequent complication with dismal prognostic consequences,” the authors wrote. “Our findings confirm that subclinical evidence of myocardial injury is frequent during COVID-19 acute phase with a prevalence of 37% in our population. Patients with myocardial injury during hospitalization, as described in other studies, were more frequently symptomatic for exertional dyspnea at follow-up evaluation.”
These findings, the group added, suggest that echocardiography can play a crucial role when it comes to identifying cardiac abnormalities and choosing the right treatment strategy for patients impacted by this ongoing pandemic.
“In patients recovered from COVID-19, TTE with speckle-tracking analysis could be a useful imaging tool to identify patients with subclinical MI and potentially guide management strategies,” they concluded.
The full analysis can be read here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.