Speckle tracking echocardiographic assessment of Left ventricular global longitudinal strain in patients recovered from COVID-19

Background: The COVID-19 infection has firmly established itself as a pandemic that can affect many body systems, including the cardiovascular system.2D speckle tracking echocardiography (2D-STE) can diagnose early subclinical myocardial dysfunction, as many studies have reported an inverse correlation of increased cardiac biomarkers level with global longitudinal strain (GLS) values among COVID-19 patients. Aim: This study assessed the global Left ventricular strain using speckle tracking echocardiography in patients recently recovered from COVID-19 infection. Patients and methods: This study was done in Benha University Hospital from June 2022 to January 2023 and included 100 patients who had positive COVID-19 diagnosis proved by positive polymerase chain reaction (PCR) test of the nasopharyngeal swab within 30 ±5 days. Results: Patients were classified according to the upper laboratory limit of the hs-troponin (11.6) into two groups; with myocardial injury (hs-troponin > 11.6) and without myocardial injury (hs-troponin ≤ 11.6). Patients with myocardial injury had significantly lower EF and LVGLS (P < 0.001). No significant differences were observed regarding ECG abnormality, D-dimer, and TLC. Moreover, LVGLS showed significant negative correlations with age (P < 0.001), hs-troponin (P = 0.013), and D-dimer (P = 0.013). In contrast, it showed a significant positive correlation with EF (P < 0.001), and no significant correlation was observed with TLC (P = 0.408). Conclusion: Serial measurements of cardiac troponin and LVGLS following recovery from COVID‐19 infection has an incremental prognostic value and can be used to evaluate the progression of sub‐clinical LV dysfunction.