Ekrem Bilal KARAAYVAZ, Berat ENGİN, Pelin KARACA ÖZER, Zeynep Gizem DEMİRTAKAN, Elif AYDUK GÖVDELİ, Turker DEMIRTAKAN, Derya BAYKIZ, Alpay MEDETALİBEYOĞLU

COVID-19 PNÖMONİSİ GEÇİRMİŞ HASTALARDA SOL VENTRİKÜL STRAİN DEĞERİNİN BÖLGESEL TUTULUMU

Amaç: Kardiyovasküler tutulumu olan COVID-19 hastalarının, kardiyovasküler tutulumu olmayanlara göre daha kötü prognoza sahip olduğu gösterilmiştir. Bu çalışma, pnömonisi olan ve olmayan COVID-19 hastalarında taburculuk sonrası sol ventrikül (LV) global ve bölgesel strain değerinin bozulup bozulmadığını araştırmaktadır. Gereç ve Yöntem: Bu kesitsel çalışmaya, PCR testi ile tanı konulan ve polikliniğimize başvuran 78 hasta dahil edildi. Tüm hastalara ilk muayenelerinde iki boyutlu ekokardiyografi ve speckle tracking ekokardiyografi (STE) yapıldı. Hastalar pnömonisi olan ve olmayan olarak iki gruba ayrıldı ve sağlıklı kontrol grubu ile karşılaştırıldı. Bulgular: Çalışmaya toplam 123 kişi alındı (78 COVID-19 hastası, 45 sağlıklı kontrol). Hem kontrol grubunda hem de farklı ciddiyetteki COVID-19 hastalarında ilk ve takip hs-troponin-T değerleri benzerdi. Sol ventrikül ejeksiyon fraksiyonu (EF) tüm gruplarda benzerdi. Bununla birlikte, sağlıklı kontroller ve pnömonisi olmayan hastalara kıyasla pnömonisi olan hastalarda LV global longitudinal straini (GLS) anlamlı ölçüde daha düşüktü. Bölgesel strain analizi, pnömonisi olmayan hastalara ve kontrol grubuna kıyasla pnömonisi olan hastaların mid-anterior, mid-anteroseptal, apikal-inferior, apikal-lateral and apeks bölgelerinde önemli ölçüde daha düşük strain değerlerine sahip olduğunu göstermiştir. Sonuç: Pnömonisi olmayan hastalara ve sağlıklı kontrollere kıyasla pnömonisi olan COVID-19 hastalarında sol ventrikül global ve bölgesel strain önemli ölçüde bozulmuştur. Bu bulgu, pnömonisi olan COVID-19 hastalarının, gizli sol ventrikül tutulumunun tespiti için strain ekokardiyografi ile değerlendirilmesi gerektiğini göstermektedir.

Anahtar Kelimeler:

COVID-19, pnömoni, sol ventrikül, bölgesel strain

REGIONAL INVOLVEMENT IN LEFT VENTRICULAR STRAIN IN PATIENTS RECOVERED FROM COVID-19 PNEUMONIA

Objective: COVID-19 patients with cardiovascular involvement have been shown to have a worse prognosis compared to those without cardiovascular compromise. This study aimed to investigate whether left ventricular (LV) global and regional strain is impaired in patients with COVID-19 with or without pneumonia after discharge. Materials and Methods: Seventy-eight consecutive COVID-19 patients diagnosed by PCR test were enrolled in this cross-sectional study during their first follow-up visit to an outpatient clinic. All patients underwent two-dimensional echocardiography and speckle tracking echocardiography (STE) at the first follow-up visit. The patients were divided into two groups with or without pneumonia, and they were compared with the healthy control group. Results: A total of 123 subjects were included in the study (78 with COVID-19 and 45 in the control group). Admission and follow-up hs-troponin-T concentrations were similar in both the control group and patients with varying severity of COVID-19. LV ejection fraction (EF) was similar in all groups. However, LV global longitudinal strain (GLS) was significantly lower in subjects with pneumonia compared to the control group and subjects without pneumonia. Regional strain analysis showed that subjects with pneumonia had significantly lower strain values at mid-anterior, mid-anteroseptal, apical-inferior, apical-lateral, and apex regions than subjects without pneumonia or the control group. Conclusion: LV GLS and the regional strain were significantly impaired in COVID-19 patients with pneumonia compared to those without pneumonia or in to control group. This finding indicates that COVID-19 subjects with pneumonia should undergo strain measurement to detect concealed LV involvement.

Keywords:

COVID-19, pneumonia, left ventricle, regional strain,

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