【摘 要】
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COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus.Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury,but imaging evidence is lacking.In the study we detected and evaluated the severity of myocard
【机 构】
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Division of Cardiology,Department of Internal Medicine and Hubei Key Laboratory of Genetics and Mole
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COVID-19 is a multiorgan systemic inflammatory disease caused by SARS-CoV-2 virus.Patients with COVID-19 often exhibit cardiac dysfunction and myocardial injury,but imaging evidence is lacking.In the study we detected and evaluated the severity of myocardial dysfunction in COVID-19 patient population using two-dimensional speckle-tracking echocardiography (2-D STE).A total of 218 consecutive patients with confirmed diagnosis of COVID-19 who had no underlying cardiovascular diseases were enrolled and underwent transthoracic echocardiography.This study cohort included 52 (23.8％) critically ill and 166 noncritically ill patients.Global longitudinal strains (GLSs) and layer-specific longitudinal strains (LSLSs) were obtained using 2-D STE.Changes in GLS were correlated with the clinical parameters.We showed that GLS was reduced (＜-21.0％) in about 83％ of the patients.GLS reduction was more common in critically sick patients (98％ vs.78.3％,P ＜ 0.001),and the mean GLS was significantly lower in the critically sick patients than those noncritical (-13.7％ ± 3.4％ vs.-17.4％ ± 3.2％,P ＜ 0.001).The alteration of GLS was more prominent in the subepicardium than in the subendocardium (P ＜ 0.001).GLS was correlated to mean serum pulse oxygen saturation (SpO2,RR =0.42,P ＜ 0.0001),high-sensitive C-reactive protein (hsCRP,R =-0.20,P =0.006) and inflammatory cytokines,particularly IL-6 (R =-0.21,P =0.003).In conclusions,our results demonstrate that myocardial dysfunction is common in COVID-19 patients,particularly those who are critically sick.Changes in indices of myocardial strain were associated with indices of inflammatory markers and hypoxia,suggesting partly secondary nature of myocardial dysfunction.
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