SPC365

Long term left ventricular impairment after SARS-COV2 infection

Session: Posters (Sessão 6 - Écran 5) - Imagem 4 - Ecocardiografia 2
Speaker: Catarina Oliveira

Congress: CPC 2022
Topic: B. Imaging
Theme: 03. Imaging
Subtheme: 03.1 Echocardiography
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Catarina Simões de Oliveira; Joana Brito; Pedro Silvério António; Pedro Simões Morais; Sara Couto Pereira; Pedro Alves da Silva; Beatriz Valente Silva; Ana Margarida Martins; Ana Beatriz Garcia; Ana Abrantes; Miguel Azaredo Raposo; Joana Rigueira; Rui Plácido; Fausto j. Pinto; Ana g. Almeida

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The impact of acute infection by SARS-COV2 on the cardiovascular (CV) system&nbsp; has been previously reported, with a higher propensity in patients (pts) with more serious pattern of disease and pro-inflammatory status. Nevertheless, the long-term burden of COVID-19 on the CV system is still unknown.</span></span></span></p>

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Purpose</strong></span></span></span></p>

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To evaluate the long-term impact of COVID-19 on left ventricular function in pts with severe clinical presentation requiring intensive care hospitalization.&nbsp;</span></span></span></p>

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">This was a single-center observational, prospective study which included pts admitted to the Intensive Care Unit (ICU) due to COVID-19 infection from January to November 2020 who accepted to perform a pos-discharge clinical evaluation. For the global longitudinal strain (GLS) analysis all pts with significant wall motion abnormalities and valvular heart disease were excluded. Statistical analysis was performed with Mann-Whitney and a safety cut-off was established with ROC curve analysis.</span></span></span></p>

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong></span></span></span></p>

<p><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">A total of 43 pts were included (mean age 64&plusmn; 12, 67.4% males). During SARS-COV2 infection 49% presented with severe ARDS and 51% with moderate, 35% required invasive mechanical ventilation, 14% noninvasive mechanical ventilation and 52%with high nasal flow cannula.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">On the follow-up fatigue was the most reported symptom (52% pts) and the majority did not present other signs or symptoms suggestive of heart failure; the mean NT-proBNP was 49&plusmn;389 pg/dL. The standard ECG and echocardiogram did not show significant differences with a mean LVEF of 58&plusmn;7.8 and mean TAPSE of 21&plusmn;4.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The GLS analysis was performed in 28 pts and a significant reduction was objected suggesting subclinical left ventricular dysfunction in this subset of pts (mean GLS of -17.14&plusmn;2.36 for a reference cut-off of -18%, t(27) = -1.928, p= 0.06)&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Maximum CPR values during ICU did not correlate either with the extent of disease evolvement in CT or ARDS severity. Nevertheless, maximum CPR correlated significantly with GLS reduction (R=0.44, p = 0.019). A CPR value higher than 30mg/dL had 100% specificity for GLS reduction and a cut-off of 14gm/dL reported a sensitivity of 65% and specificity of 75% for reduction in GLS.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span><br />
<span style="font-size:10pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">In our study, we reported subclinical impairment in left ventricular function detected with GLS after serious infection with SARS-COV2. The detected myocardial dysfunction correlated significantly with higher CPR values. Therefore, pts with higher inflammatory response should undergo a cardiologic evaluation.</span></span></span></p>

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