Speckle-tracking echocardiography in coronavirus infection

Speckle-tracking echocardiography is a promising modern technique for assessing structural and functional changes in the myocardium in coronavirus infection, which is important for long-term prognosis.

The aim of this study is to identify and evaluate myocardial effects in COVID-19 infected patients by echocardiography using specialized advanced imaging and a protocol to analyze the various components of myocardial deformity.

RESULTS AND METHODS An extended echocardiographic imaging protocol was performed in 57 patients with SARSCoV-2 infection, assessing longitudinal, radial, and circumferential LV deformity, including rotation, torsion, and torsion. In addition, LV deformity was analyzed in an age-matched control group of healthy individuals (n=20). The most predominant finding was a reduction in longitudinal deformity, predominantly in more than one LV basal segment (n=39/57 patients, 69 %). This pattern resembled the “reverse tako-tsubo” morphology, which is not typical of other viral myocarditis. Additional findings included a biphasic pattern with maximal post-systolic or negative regional radial deformity, predominantly basal (n=21/57 patients, 37 %); absence or dispersion of LV basal rotation (n=28/57 patients, 50 %); reduced or positive regional circumferential deformity in more than one segment (n = 31/57 patients, 50 %).

Conclusion. Myocardial involvement caused by SARS-CoV-2 can be characterized by specific patterns of LV deformity, even in patients with mild/moderate symptoms. Detection of myocardial involvement by speckle tracking echocardiography is possible in the acute stage of COVID-19, which may improve early detection of myocardial injury, risk of stratification, and potentially cardioprotective treatment.

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