Mustafa DOĞAN, Lütfi Çağatay ONAR, Aykut DEMİRKIRAN

Decrease of left ventricular ejection fraction in severe illness patients due to COVID-19 may improve as the disease resolves

Background/aim: Increase in publications supporting myocardial involvement in the COVID-19 disease has led to need to gain insight into the the global burden of heart failure after pandemic. We examined the course of myocardial systolic function in patients without elevated troponin levels. Materials and methods: We performed a prospective study. Patients with high troponin levels were excluded from the study in order to definitively exclude complications known to cause permanent left ventricular systolic dysfunction, such as acute coronary syndromes. Two echocardiographic examinations were performed. The first evaluation was performed within the days of hospitalization, if possible, on the day when dyspnea is severe. The second evaluation was performed during the outpatient clinic controls one month after the patient was recovered. Left ventricular ejection fraction (LVEF) was measured using the biplane method of disks (modified Simpson’s rule). Results: In the first evaluation, LVEF was found to be significantly lower in the severe illness group than mild/moderate illness group (50 ± 6% and 59 ± 6%; p = 0.03). LVEF decrease (

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1. Libby P. The Heart in COVID-19: Primary target or secondary bystander? Journals of the American College of Cardiology: Basic to Translational Science. 2020; 5 (5): 537-542. doi: 10.1016/j.jacbts.2020.04.001
2. Atri D, Siddiqi HK, Lang JP, Nauffal V, Morrow DA et al. COVID-19 for the cardiologist: basic virology, epidemiology, cardiac manifestations, and potential therapeutic strategies. Journals of the American College of Cardiology: Basic to Translational Science. 2020; 5 (5): 518-536. doi: 10.1016/j. jacbts.2020.04.002
3. Ammirati E, Wang DW. SARS-CoV-2 inflames the heart. The importance of awareness of myocardial injury in COVID-19 patients. International Journal of Cardiology. 2020; 311: 122- 123. doi: 10.1016/j.ijcard.2020.03.086
4. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. Journals of the American College of Cardiology. 2020; 75 (18): 2352-2371. doi: 10.1016/j.jacc.2020.03.031
5. Mokhtari T, Hassani F, Ghaffari N, Ebrahimi B, Yarahmadi A et al. COVID-19 and multiorgan failure: A narrative review on potential mechanisms. Journal of molecular histology. 2020; 51 (6): 613–628. doi: 10.1007/s10735-020-09915-3
6. Akhmerov A, Marbán E. COVID-19 and the heart. Circulation Research. 2020; 126 (10):1443-1455. doi: 10.1161/ CIRCRESAHA.120.317055
7. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. Journal of the American Medical Association. 2020; 323 (13): 1239–1242. doi:10.1001/jama.2020.2648
8. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. American Journal of Emergency Medicine. 2020; 38 (7): 1504-1507. doi: 10.1016/j. ajem.2020.04.048
9. Tersalvi G, Vicenzi M, Calabretta D, Biasco L, Pedrazzini G et al. Elevated troponin in patients with coronavirus disease 2019: possible mechanisms. Journal of Cardiac Failure. 2020; 26 (6): 470-475. doi: 10.1016/j.cardfail.2020.04.009
10. Suzuki T, Ito M, Kodama M, Mitsuma W, Izumi D et al. Transient left ventricular dysfunction associated with severe Legionella infection. Journal of Cardiology Cases. 2011; 3 (2): 78-81. doi: 10.1016/j.jccase.2011.01.002
11. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN et al. Surviving sepsis campaign: guidelines on the management of critically Ill adults with coronavirus disease 2019 (COVID-19). Critical Care Medicine. 2020; 48 (6): 440-469. doi: 10.1097/ CCM.0000000000004363
12. Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovascular Research. 2020; 116 (10): 1666-1687. doi: 10.1093/cvr/cvaa106
13. Medina de Chazal H, Del Buono MG, Keyser-Marcus L, Ma L, Moeller FG et al. Stress cardiomyopathy diagnosis and treatment: JACC State-of-the-Art Review. Journals of the American College of Cardiology. 2018; 72 (16): 1955-1971. doi: 10.1016/j.jacc.2018.07.072