The goal of this observational study is to retrospectively analyze left atrial functionin mild to moderate COVID-19-recovered patients. The main questions it aims to answerare: - Whether left atrial function is involved in patients with mild to moderate COVID-19 after recovery. - What are the factors that may be associated with persistent heart-related symptoms (including chest pain, chest tightness, palpitations, shortness of breath, or postural tachycardia) in patients with mild to moderate COVID-19 ?Participants will undergo transthoracic echocardiography to obtain conventionalultrasound parameters, two-dimensional strain parameters will been obtained throughsoftware post-processing, and general clinical data and laboratory test results will beenobtained.
The included patients who recovered from COVID-19 infection and healthy people underwent
transthoracic echocardiography at the First Affiliated Hospital of Shandong First Medical
University from December 20, 2022 to January 20, 2023. Routine data and two-dimensional
strain parameters of transthoracic echocardiography of the study subjects were obtained:
1. The echocardiographic examination was performed using a Epiq 7C ultrasound machine,
and images were acquired with the patient in left lateral decubitus using a 3.5-5
MHz transducer at a depth of 16 cm. ECG was recorded, and 3 consecutive cardiac
cycles of each view were recorded during quiet breathing at 50-80 frames/sec. All
patients were subjected to conventional transthoracic echocardiography & Speckle
tracking echocardiography (STE). All measurements were taken following the American
Society of Echocardiography (ASE) recommendations.
2. Left atrial strain analysis was obtained using automated speckle tracking software.
The regions of interest were generated automatically and Left atrial endocardial
border was manually adjusted when required. Left atrial phases definition and Left
atrial strain values were measured from the Left atrial longitudinal strain curve
according to the European Association of Cardiovascular Imaging (EACVI)/American
society of echocardiography (ASE) guidelines. Global LV systolic strain was
evaluated, and the software automatically traced the contour of the endocardium at
apical three, four and two-chamber views.
3. At the same time, the general clinical data, demographic characteristics,
electrocardiogram, chest CT results, troponin I (hsTnI) and brain natriol peptide
levels on the day of echocardiographic examination were obtained through the
hospital electronic medical record His system.
4. Clinical follow-up was performed 12-18 months after the echocardiographic
examination by phone and by electronic health record review. We recorded: 1)
persistent cardiac symptoms, 2) interval presentation to the emergency department or
hospitalization with cardiac symptoms, and 3) any major adverse cardiac event
(myocardial infarction, stroke, revascularization, or death).
Other: two-dimensional speckle tracking echocardiography
The structural and functional parameters of the left atrial were obtained by conventional
echocardiography, and the left atrial strain parameters were obtained by two-dimensional
speckle tracking echocardiography.
Inclusion Criteria:
- 1. Patients having been diagnosed with SARS-CoV-2 Omicron variant infection based on
real-time reverse-transcription polymerase chain reaction (RT-PCR) results; 2.
Asymptomatic or mild to moderate COVID-19 patients. 3.COVID-19 patients who came to
our hospital for echocardiography within 3 months after recovery.
Exclusion Criteria:
- Patients with decreased left ventricular ejection fraction (less than 50%), left
ventricular segmental wall motion abnormalities, cardiomyopathy, severe valvular
heart disease, arrhythmia, thyroid dysfunction, pulmonary hypertension, past or
current pulmonary embolism, severe chronic obstructive pulmonary disease,
malignancy/renal failure (less than 30) ml/min) or poor cardiogram image quality
were excluded from the study.
The First Affiliated Hospital of Shandong First Medical University
Jinan 1805753, Shandong 1796328, China
Haiyan Wang, Principal Investigator
Shandong First Medical University