Myocardial Dysfunction and Risk of Long COVID in Patients Recovered From Mild and Moderate COVID-19

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-03-03 DOI:10.1111/echo.70120

Binyu Zhou, Yiran Zhang, Shuang Han, Jiqing Zhang, Lin Song, Haiyan Wang

{"title":"Myocardial Dysfunction and Risk of Long COVID in Patients Recovered From Mild and Moderate COVID-19","authors":"Binyu Zhou, Yiran Zhang, Shuang Han, Jiqing Zhang, Lin Song, Haiyan Wang","doi":"10.1111/echo.70120","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Numerous recovered COVID-19 patients exhibit persistent cardiovascular symptoms. However, the degree of myocardial dysfunction and its associated risk factors remain unclear. This study aims to evaluate myocardial dysfunction in recovered patients and pinpoint predictors of persistent cardiovascular symptoms.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We reviewed the echocardiograms of patients who recovered from mild or moderate COVID-19 and presented with cardiovascular symptoms during the Omicron surge. Myocardial strain was analyzed in 546 patients before and after infection, and in 351 prepandemic healthy controls. Clinical follow-up at 12 months post-infection was used to evaluated symptom persistence, and multivariable logistic regression was used to identify independent predictors.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Baseline characteristics showed no significant differences between patients and controls (all <i>p</i> > 0.05). Although the left ventricle global longitudinal strain (LVGLS) remained stable post-infection, significant reductions emerged in regional left ventricle longitudinal strains (LVLS) and all left atrial strains (LAS) (all <i>p</i> < 0.05). Persistent cardiovascular symptoms affected 16.5% (90/546) of patients at 1-year follow-up. Multivariate analysis showed that only LA conduit strain (OR = 0.919, 95% CI: 0.857, 0.985, <i>p</i> = 0.017) and basal inferoseptal LVLS (OR = 0.883, 95% CI: 0.792, 0.986, <i>p</i> = 0.026) correlated with persisting cardiovascular symptoms.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Our findings demonstrate that subclinical but persistent COVID-19-associated myocardial dysfunction is characterized by regional LVLS impairment and LAS reduction. The identified strain parameters (LAScd and basal inferoseptal LVLS) serve as novel imaging markers for stratifying patients at risk of persistent cardiovascular symptoms. These results advocate for targeted echocardiographic surveillance and early intervention strategies in post-COVID care pathways.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>ClinicalTrials.gov identifier: NCT06170307</p>\n </section>\n </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70120","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/echo.70120","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Numerous recovered COVID-19 patients exhibit persistent cardiovascular symptoms. However, the degree of myocardial dysfunction and its associated risk factors remain unclear. This study aims to evaluate myocardial dysfunction in recovered patients and pinpoint predictors of persistent cardiovascular symptoms.

Methods

We reviewed the echocardiograms of patients who recovered from mild or moderate COVID-19 and presented with cardiovascular symptoms during the Omicron surge. Myocardial strain was analyzed in 546 patients before and after infection, and in 351 prepandemic healthy controls. Clinical follow-up at 12 months post-infection was used to evaluated symptom persistence, and multivariable logistic regression was used to identify independent predictors.

Results

Baseline characteristics showed no significant differences between patients and controls (all p > 0.05). Although the left ventricle global longitudinal strain (LVGLS) remained stable post-infection, significant reductions emerged in regional left ventricle longitudinal strains (LVLS) and all left atrial strains (LAS) (all p < 0.05). Persistent cardiovascular symptoms affected 16.5% (90/546) of patients at 1-year follow-up. Multivariate analysis showed that only LA conduit strain (OR = 0.919, 95% CI: 0.857, 0.985, p = 0.017) and basal inferoseptal LVLS (OR = 0.883, 95% CI: 0.792, 0.986, p = 0.026) correlated with persisting cardiovascular symptoms.

Conclusion

Our findings demonstrate that subclinical but persistent COVID-19-associated myocardial dysfunction is characterized by regional LVLS impairment and LAS reduction. The identified strain parameters (LAScd and basal inferoseptal LVLS) serve as novel imaging markers for stratifying patients at risk of persistent cardiovascular symptoms. These results advocate for targeted echocardiographic surveillance and early intervention strategies in post-COVID care pathways.

Trial Registration

ClinicalTrials.gov identifier: NCT06170307

Abstract Image

查看原文本刊更多论文

轻、中度新冠肺炎康复患者心肌功能障碍与长冠风险

许多康复的COVID-19患者表现出持续的心血管症状。然而，心肌功能障碍程度及其相关危险因素尚不清楚。本研究旨在评估康复患者的心肌功能障碍，并确定持续心血管症状的预测因素。方法回顾在Omicron激增期间出现心血管症状的轻、中度COVID-19患者的超声心动图。分析了546例感染前后患者和351例大流行前健康对照者的心肌应变。感染后12个月的临床随访用于评估症状持续性，并使用多变量logistic回归确定独立预测因子。结果患者与对照组的基线特征无显著差异(p >；0.05)。尽管感染后左心室整体纵应变（LVGLS）保持稳定，但局部左心室纵应变（LVLS）和所有左心房应变（LAS）均出现显著降低(p <；0.05)。1年随访时，16.5%（90/546）的患者出现持续心血管症状。多因素分析显示，只有左心室导管应变（OR = 0.919, 95% CI: 0.857, 0.985, p = 0.017）和基底隔间LVLS （OR = 0.883, 95% CI: 0.792, 0.986, p = 0.026）与持续的心血管症状相关。结论与新冠肺炎相关的亚临床但持续的心肌功能障碍以局部LVLS损伤和LAS降低为特征。所确定的应变参数（LAScd和基底隔间LVLS）可作为对有持续心血管症状风险的患者进行分层的新型成像标记。这些结果提倡在covid - 19后护理途径中进行有针对性的超声心动图监测和早期干预策略。临床试验注册信息：NCT06170307

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.