Myocardial Work Indices in Patients Recently Recovered from Mild-to-Moderate COVID-19.

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In Clinical Literature.

Myocardial Work Indices in Patients Recently Recovered from Mild-to-Moderate COVID-19.

Publication date: Jul 12, 2024

Background/Objectives: Persistent cardiovascular issues are common in COVID-19 survivors, making the detection of subtle myocardial injuries critical. This study evaluates myocardial work (MW) indices in patients recently recovering from mild-to-moderate COVID-19. Methods: A total of 105 recently recovered COVID-19 patients (who had a mean age of 52 years) underwent comprehensive laboratory testing and advanced echocardiographic assessments. The median time since their COVID-19 infections was 56 days (IQR: 42-71). The cohort was stratified based on high-sensitive troponin I (hs-TnI) levels: undetectable versus detectable. The echocardiographic analysis utilized pressure-strain loops to evaluate MW indices. Results: Detectable hs-TnI levels were observed in 42% of patients. The median values of MW indices for the entire group were slightly below normal values: global work index (GWI)-1834 mmHg% (IQR 1168-2054 mmHg%), global constructive work (GCW)-2130 mmHg% (IQR 2010-2398 mmHg%), global wasted work (GWW)-119 mmHg% (IQR 78-175 mmHg%), and global work efficiency (GWE)-94% (IQR 92-96%). Patients with detectable hs-TnI had higher GWW (168 vs. 97 mmHg%, p < 0. 005) and lower GWE (93% vs. 95%, p < 0. 005). In multiple regression analysis, strain dispersion (PSD) was the sole predictor for GWW (β = 0. 67, p < 0. 001), while for GWE, PSD (β = -0. 67, p < 0. 001) and LVEF (β = 0. 16, p = 0. 05) were significant predictors. Conclusions: Among patients recently recovering from mild-to-moderate COVID-19, elevated hs-TnI levels are linked with a reduction in GWE and an increase in GWW. PSD is an important predictor of myocardial inefficiency and wasted work. In this group, disruptions in the timing and coordination of cardiac muscle contractions may play a key pathophysiological role in reducing the efficiency of the heart's performance.

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Concepts Keywords
Laboratory COVID-19
Myocardial echocardiography
Survivors high-sensitive troponin I
myocardial injury
myocardial work
peak strain dispersion

Semantics

Type Source Name
disease MESH COVID-19
disease VO time
disease MESH infections
disease VO efficiency
drug DRUGBANK Uridine monophosphate
drug DRUGBANK Coenzyme M
disease VO organ
disease MESH inflammation
disease MESH critically ill
disease MESH long COVID
disease IDO process
disease IDO acute infection
disease IDO site
disease IDO infection
disease VO vaccination
disease IDO history
disease MESH complications
disease IDO blood
drug DRUGBANK Creatinine
disease VO population
disease MESH Global Longitudinal Strain
drug DRUGBANK Hexachlorophene
drug DRUGBANK Trestolone
drug DRUGBANK Cysteamine
disease VO device
drug DRUGBANK Esomeprazole
disease VO USA
disease IDO quality
drug DRUGBANK Oxygen
drug DRUGBANK Tocilizumab
drug DRUGBANK Acetaminophen
drug DRUGBANK Acetylsalicylic acid
disease MESH atrial fibrillation
disease MESH Bradycardia
disease MESH tachycardia
disease MESH atrioventricular block
disease MESH bundle branch block
disease MESH Hypertension
disease MESH Diabetes mellitus
disease MESH Asthma
pathway KEGG Asthma
disease VO volume

Original Article

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