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USE OF STRAIN IMAGING TO DETECT SUBTLE MYOCARDIAL INVOLVEMENT IN POST COVID-19 PATIENTS: AN INDIAN PERSPECTIVE
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  • Deepak Tomar,
  • Aditya Kapoor,
  • Zia Hashim,
  • Kamlesh Raut,
  • Arpita Katheria,
  • Harshit khare,
  • ANKIT SAHU,
  • Roopali Khanna,
  • Sudeep Kumar,
  • Naveen Garg,
  • Satyendra Tewari
Deepak Tomar
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Aditya Kapoor
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology

Corresponding Author:akapoor65@gmail.com

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Zia Hashim
Sanjay Gandhi Post Graduate Institute of Medical Sciences
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Kamlesh Raut
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Arpita Katheria
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Harshit khare
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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ANKIT SAHU
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Roopali Khanna
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Sudeep Kumar
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Naveen Garg
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Satyendra Tewari
Sanjay Gandhi Post Graduate Institute of Medical Sciences Department of Cardiology
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Abstract

Background: Global longitudinal strain (GLS) imaging by echocardiography is an objective, well validated and cost-effective modality for detecting subtle left ventricular function abnormalities. Aim: We assessed the prevalence of subtle myocardial dysfunction among patients clinically recovered from COVID-19 using echocardiographic strain imaging. Results: Amongst 101 post COVID-19 patients (76% males, mean age 55.45±11.14 years), prevalence of diabetes mellitus, hypertension and dyslipidemia was comparable to 30 controls. The average GLS was significantly lesser in post COVID patients (-16.21 ± 1.96 vs -18.49 ± 1.64, p = 0.004) and significantly higher proportion of post COVID patients had GLS > -18% (43% vs 22.58%, p =0.001) as compared to controls. The RV free wall longitudinal strain (RVFLS) was also lower in the patient group (22.35 ± 4.69 vs 24.19 ± 4.11, p =0.004) and 21.7% post COVID-19 patients had impaired RV FWLS (> -20%) vs controls (6.6%). Average GLS was significantly lesser in severe post COVID patients (viz -14.25 ± 1.92 vs -16.63 ± 1.61 vs -17.63 ± 1.91, p < 0.0001, respectively among severe, moderate and mild COVID-19 patients. On performing regression analysis, severity of COVID-19 (OR 7.762) was a significant predictor of impaired GLS. Conclusion: Despite clinical recovery and normal LVEF, post COVID-19 patients had significantly lower LV GLS and RV FWLS. Those with severe COVID-19 infection, had worse LV GLS and RV FWLS as compared to those with milder infection. This study reiterates the importance of speckle tracking echocardiography as an important imaging modality for detection of subclinical myocardial dysfunction in the post COVID-19 recovered patients.