超声心动图评估 COVID-19 后儿童的心功能和运动储备:前瞻性横断面研究

Mikiko Harada MD, PhD, Tobias Engl, Katharina Köble MSc, Frauke Mühlbauer MD, Lisa Baumgartner MPH, PhD, Daniel Goeder MSc, Maximilian Dettenhofer MD, Renate Oberhoffer-Fritz MD, PhD
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引用次数: 0

摘要

背景在患有 2019 年冠状病毒病(COVID-19)的成年人中观察到心血管功能受损,即使是那些症状轻微的人。体力活动可揭示静息状态下不明显的微妙心血管功能障碍。然而,有关儿童和青少年感染COVID-19后心血管功能的数据十分有限。本研究旨在通过静息时二维经胸超声心动图(TTE-R)和运动负荷超声心动图(ESE)评估有 COVID-19 感染史的儿童和青少年以及对照组的心血管功能。一部分男性参与者(40 例,15 例对照组)接受了结合心肺运动测试(CPET-ESE)的 ESE,以检查心血管参数与心肌收缩力储备之间的关系。通过测量运动时应变值的最大增幅来评估心肌收缩力储备。感染组的右心室和左心室收缩力在临床上与对照组相当。在 CPET-ESE 过程中,感染组和对照组的峰值耗氧量相似。结论我们发现,通过 TTE-R 评估,有轻度 COVID-19 感染史的参与者与对照组在左心室收缩和舒张功能以及右心室收缩功能方面没有明显差异。ESE 为感染 COVID-19 后的年轻人恢复活动和运动提供了启示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Echocardiographic Assessment of Cardiac Function and Reserve Under Exercise in Post–COVID-19 Children: A Prospective Cross-sectional Study

Background

Cardiovascular impairment has been observed in adults with coronavirus disease 2019 (COVID-19), even in those with mild symptoms. Physical activity can reveal subtle cardiovascular dysfunction that is not apparent at rest. However, there are limited data on cardiovascular function in children and adolescents after the COVID-19 infection. This study aimed to assess cardiovascular function in paediatric and adolescent populations with a history of COVID-19 infection and controls by conducting 2-dimensional transthoracic echocardiography at rest (TTE-R) and exercise stress echocardiography (ESE).

Methods

We conducted TTE-R, including speckle tracking strain analysis of both ventricles, on 100 individuals (median age 12.3 years, 82% male), divided into 2 groups: 73 adolescents with COVID-19 infection and 27 controls. A subset of male participants (40 cases, 15 controls) underwent ESE combined with a cardiopulmonary exercise test (CPET-ESE) to examine the relationship between cardiovascular parameters and contractile reserve. Myocardial contractile reserve was evaluated by measuring the maximum increase in strain values during exercise.

Results

At rest, no signs of myocardial injury or inflammation were observed. Right and left ventricular contractility in the infected group were clinically equivalent to those in the controls. During CPET-ESE, peak oxygen consumption was similar between the infected and control groups. Furthermore, contractile reserve under exercise was similar in both groups.

Conclusions

We found no significant differences in left ventricular systolic and diastolic function and right ventricle systolic function evaluated by TTE-R between participants with a history of mild COVID-19 infection and controls. ESE provided insights for post–COVID-19 young people resuming activities and sports.
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