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Purpose <p>Impaired left and right ventricular (LV/RV) function during acute SARS-CoV-2 infection has been predominantly reported in hospitalized patients, but long-term cardiac sequelae in large, well-characterized cohorts remain inconclusive. This study evaluated cardiac structure and function in individuals with post-Coronavirus disease (COVID) syndrome (PCS) compared to recovered controls (CON), focusing on associations with cardiopulmonary symptoms and rapid physical exhaustion (RPE).</p> Methods <p>This multicenter, population-based study included 1154 participants (679 PCS, 475 age- and sex matched CON; mean age 49 ± 12 years; 760 women) 1.5 years post-infection. Transthoracic echocardiography assessed LV global longitudinal strain (GLS), RV GLS and RV free wall strain (FWS), and other measures. Cardiopulmonary exercise testing (CPET) measured maximum respiratory oxygen uptake (VO<sub>2</sub>max) as a marker of cardiopulmonary fitness.</p> Results <p>PCS participants exhibited significantly lower LV GLS (-20.25% [-21.28 – -19.22] vs. -20.73% [-21.74 – -19.72], <i>p</i> = 0.003), reduced diastolic function (E/A 1.16 [1.04–1.27] vs. 1.21 [1.1–1.32], <i>p</i> = 0.022) and decreased TAPSE (24.45&#xa0;mm [22.14–26.77] vs. 25.05&#xa0;mm [22.78–27.32], <i>p</i> = 0.022) compared to CON, even after adjusting for confounders. RV strain values were similar between groups. LV GLS correlated inversely with VO<sub>2</sub>max (<i>p</i> = 0.004) and positively with RPE (<i>p</i> = 0.050), though no associations were observed with other cardiopulmonary symptoms.</p> Conclusions <p>This study demonstrates subtle yet consistent reductions in LV function, specifically LV GLS and diastolic function, and exercise capacity in PCS compared to CON. While these changes are within reference ranges, their potential impact on clinical outcomes warrants further investigation. These findings highlight the need for cardiac assessments and long-term follow-up in symptomatic PCS patients.</p>

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Cardiac structure and function 1.5 years after COVID-19: results from the EPILOC study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月24日

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  • Jana Schellenberg,
  • Lynn Matits,
  • Daniel A. Bizjak,
  • Peter Deibert,
  • Birgit Friedmann-Bette,
  • Siri Göpel,
  • Uta Merle,
  • Andreas Niess,
  • Norbert Frey,
  • Oliver Morath,
  • Gunnar Erz,
  • Raphael S. Peter,
  • Alexandra Nieters,
  • Dietrich Rothenbacher,
  • Winfried V. Kern,
  • Jürgen M. Steinacker

摘要

Purpose

Impaired left and right ventricular (LV/RV) function during acute SARS-CoV-2 infection has been predominantly reported in hospitalized patients, but long-term cardiac sequelae in large, well-characterized cohorts remain inconclusive. This study evaluated cardiac structure and function in individuals with post-Coronavirus disease (COVID) syndrome (PCS) compared to recovered controls (CON), focusing on associations with cardiopulmonary symptoms and rapid physical exhaustion (RPE).

Methods

This multicenter, population-based study included 1154 participants (679 PCS, 475 age- and sex matched CON; mean age 49 ± 12 years; 760 women) 1.5 years post-infection. Transthoracic echocardiography assessed LV global longitudinal strain (GLS), RV GLS and RV free wall strain (FWS), and other measures. Cardiopulmonary exercise testing (CPET) measured maximum respiratory oxygen uptake (VO2max) as a marker of cardiopulmonary fitness.

Results

PCS participants exhibited significantly lower LV GLS (-20.25% [-21.28 – -19.22] vs. -20.73% [-21.74 – -19.72], p = 0.003), reduced diastolic function (E/A 1.16 [1.04–1.27] vs. 1.21 [1.1–1.32], p = 0.022) and decreased TAPSE (24.45 mm [22.14–26.77] vs. 25.05 mm [22.78–27.32], p = 0.022) compared to CON, even after adjusting for confounders. RV strain values were similar between groups. LV GLS correlated inversely with VO2max (p = 0.004) and positively with RPE (p = 0.050), though no associations were observed with other cardiopulmonary symptoms.

Conclusions

This study demonstrates subtle yet consistent reductions in LV function, specifically LV GLS and diastolic function, and exercise capacity in PCS compared to CON. While these changes are within reference ranges, their potential impact on clinical outcomes warrants further investigation. These findings highlight the need for cardiac assessments and long-term follow-up in symptomatic PCS patients.