Prominent Longitudinal Strain Reduction of Basal Left Ventricular Segments in Patients with COVID-19

Background COVID-19 has been associated with overt and subclinical myocardial dysfunction We observed a recurring pattern of reduced basal left ventricular (LV) longitudinal strain (LS) on speckle-tracking echocardiography (STE) in hospitalized COVID-19 patients and subsequently aimed to identify characteristics of affected patients We hypothesized that COVID-19 patients with reduced basal LV strain would demonstrate elevated cardiac biomarkers Methods 81 consecutive COVID-19 patients underwent STE Those with poor quality STE (n=2) or known LV ejection fraction<50% (n=4) were excluded Patients with absolute value basal LS<13 9% (2SD below normal) were designated as cases (n=39);those with basal LS≥13 9% as controls (n=36) Demographics and clinical variables were compared Results Of 75 included patients (mean age 62±14 years, 41% women), 52% had reduced basal strain Cases had higher BMI (median[IQR]) (34 1[26 5-37 9]kg/m2 vs 26 9[24 8-30 0]kg/m2, p=0 009), and greater proportions of Black (74% vs 36%, p=0 0009), hypertensive (79% vs 56%, p=0 026) and diabetic patients (44% vs 19%, p=0 025) compared to controls Troponin and NT-proBNP levels trended higher in cases but were not significantly different Conclusions and Relevance Reduced basal LV strain is common in COVID-19 patients Patients with hypertension, diabetes, obesity, and Black race were more likely to have reduced basal strain Further investigation into the significance of this strain pattern is warranted