Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Cardiac Phenotyping of SARS-CoV-2 in British Columbia: A Prospective Echo Study With Strain Imaging

  • Jeffrey Yim (Division of Cardiology, University of British Columbia) ;
  • Michael Y.C. Tsang (Division of Cardiology, University of British Columbia) ;
  • Anand Venkataraman (Division of Cardiology, University of British Columbia) ;
  • Shane Balthazaar (Division of Cardiology, University of British Columbia) ;
  • Ken Gin (Division of Cardiology, University of British Columbia) ;
  • John Jue (Division of Cardiology, University of British Columbia) ;
  • Parvathy Nair (Division of Cardiology, University of British Columbia) ;
  • Christina Luong (Division of Cardiology, University of British Columbia) ;
  • Darwin F. Yeung (Division of Cardiology, University of British Columbia) ;
  • Robb Moss (Division of Cardiology, University of British Columbia) ;
  • Sean A Virani (Division of Cardiology, University of British Columbia) ;
  • Jane McKay (Department of Medicine, University of British Columbia) ;
  • Margot Williams (Division of Cardiology, University of British Columbia) ;
  • Eric C. Sayre (Arthritis Research Canada) ;
  • Purang Abolmaesumi (Department of Electrical and Computer Engineering, University of British Columbia) ;
  • Teresa S.M. Tsang (Division of Cardiology, University of British Columbia)
  • Received : 2022.10.16
  • Accepted : 2023.01.29
  • Published : 2023.07.27
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Abstract

BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.

Keywords

Acknowledgement

We would like to acknowledge the Post-COVID-19 Recovery Clinic at St. Paul's Hospital and Vancouver General Hospital for their contribution to this study.

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