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COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden

Author

Listed:
  • Antonello D’Andrea

    (Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
    Unit of Cardiology and Intensive Coronary Care, “Umberto I” Hospital, 84014 Nocera Inferiore, Italy)

  • Luigi Cante

    (Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy)

  • Stefano Palermi

    (Department of Public Health, University of Naples Federico II, 80131 Naples, Italy)

  • Andreina Carbone

    (Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy)

  • Federica Ilardi

    (Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy)

  • Francesco Sabatella

    (Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy)

  • Fabio Crescibene

    (Unit of Cardiology, Scafati M. Scarlato COVID Hospital (ASL Salerno), 84018 Scafati, Italy)

  • Marco Di Maio

    (Unit of Cardiology, Eboli Hospital (ASL Salerno), 84025 Eboli, Italy)

  • Francesco Giallauria

    (Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy)

  • Giancarlo Messalli

    (Unit of Radiology, Sarno Hospital (ASL Salerno), 84087 Salerno, Italy)

  • Vincenzo Russo

    (Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy)

  • Eduardo Bossone

    (Cardiac Rehabilitation Unit, Cardarelli Hospital, 80131 Naples, Italy)

Abstract

SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous. Furthermore, the full diagnostic algorithm can be hindered by logistical difficulties related to the transportation of COVID-19 patients in a critical condition to the radiology department. Our aim was to study longitudinal systolic cardiac function in patients with COVID-19-related myocarditis with echocardiography and to compare these findings with cardiac magnetic resonance (CMR) results. Patients with confirmed acute myocarditis and age- and gender-matched healthy controls were enrolled. Both patients with COVID-19-related myocarditis and healthy controls underwent standard transthoracic echocardiography and speckle-tracking analysis at the moment of admission and after 6 months of follow-up. The data of 55 patients with myocarditis (mean age 46.4 ± 15.3, 70% males) and 55 healthy subjects were analyzed. The myocarditis group showed a significantly reduced global longitudinal strain (GLS) and sub-epicardial strain, compared to the control ( p < 0.001). We found a positive correlation (r = 0.65, p < 0.0001) between total scar burden (TSB) on CMR and LV GLS. After 6 months of follow-up, GLS showed marked improvements in myocarditis patients on optimal medical therapy ( p < 0.01). Furthermore, we showed a strong association between baseline GLS, left ventricular ejection fraction (LVEF) and TSB with LVEF at 6 months of follow-up. After a multivariable linear regression analysis, baseline GLS, LVEF and TSB were independent predictors of a functional outcome at follow-up ( p < 0.0001). Cardiac function and myocardial longitudinal deformation, assessed by echocardiography, are associated with TSB at CMR and have a predictive value of functional recovery in the follow-up.

Suggested Citation

  • Antonello D’Andrea & Luigi Cante & Stefano Palermi & Andreina Carbone & Federica Ilardi & Francesco Sabatella & Fabio Crescibene & Marco Di Maio & Francesco Giallauria & Giancarlo Messalli & Vincenzo , 2022. "COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden," IJERPH, MDPI, vol. 19(10), pages 1-10, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:10:p:5898-:d:814300
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    Cited by:

    1. Alessandro Corsini & Andrea Bisciotti & Raffaele Canonico & Andrea Causarano & Riccardo Del Vescovo & Pierluigi Gatto & Paolo Gola & Massimo Iera & Stefano Mazzoni & Paolo Minafra & Gianni Nanni & Giu, 2023. "Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship," IJERPH, MDPI, vol. 20(6), pages 1-13, March.

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