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

Antonello D’Andrea, Luigi Cante, Stefano Palermi, Andreina Carbone, Federica Ilardi, Francesco Sabatella, Fabio Crescibene, Marco Di Maio, Francesco Giallauria, Giancarlo Messalli, Vincenzo Russo and Eduardo Bossone
Additional contact information
Antonello D’Andrea: Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, 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

IJERPH, 2022, vol. 19, issue 10, 1-10

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.

Keywords: myocarditis; COVID-19; speckle-tracking echocardiography; cardiac magnetic resonance; total scar burden (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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