Non-ischemic Primary and Secondary Cardiomyopathy

1352513 - Do Abnormalities in Left And Right Ventricular CMR-Global Strain Precede Ejection Fraction Decline in Patients With Documented Covid-19 Inflammatory Heart Disease By Modified Lake Louise Criteria?

Wednesday, January 25, 2023

Location: E-POSTER

Presenting Author(s)

MK

Muhammad Umar Khalid, MD

Fellow
Cleveland Clinic
Cleveland, Ohio, United States

Primary Author(s)

MK

Muhammad Umar Khalid, MD

Fellow
Cleveland Clinic
Cleveland, Ohio, United States

Co-Author(s)

JM

J. Ronald Mikolich, MD

Professor
Northeast Ohio Medical University
Sharon, Pennsylvania, United States
Robert Biederman, MD

Director
Allegheny Health Network
Pittsburgh, Pennsylvania, United States

Disclosure(s):

Robert Biederman, MD: No financial relationships to disclose

Background: LV and RV strain abnormalities have been proposed to occur prior to observed global LV and RV dysfunction in post COVID-19 (COVID) inflammatory heart disease (IHD) patients. Early studies suggest that LV and RV involvement is greater than expected in patients with COVID. This study is designed to evaluate LV and RV strain abnormalities in COVID patients with and without ventricular dysfunction as compared to healthy controls.

Methods: A retrospective COVID IHD CMR database was analyzed. IHD diagnosis was based on the Modified Lake Louise Criteria (MLLC). COVID patients and healthy controls underwent LV global longitudinal strain (LVGLS), LV global circumferential strain (LVGCS), RV global longitudinal strain (RVGLS) and RV global circumferential strain (RVGCS) measurements using CMR Fast strain encoded imaging (Fast-SENC).

Results: In total, 56 COVID patients diagnosed with IHD via MLLC: 48 (85%) patients had normal LVEF and 8 (14%) had an abnormal LVEF. Mean LVGLS was -15.9% in COVID 19 patients with normal LVEF as compared to -16.2% in patients with abnormal LVEF (p=NS). Similarly, mean LVGCS was -16.1% in patients with COVID IHD and normal LVEF vs. -16.3% in pts with abnormal LVEF (p=NS). These values were statistically different when compared to the group of 197 normal controls with no documented IHD by MLLC and mean LVGLS of -20.9% and LVGCS of -19.7% (p< 0.01). Similarly, 43 of 56 COVID IHD patients had abnormal RVEF with mean RVGLS of -16.4% versus -17% in the normal RVEF group (p= 0.11). Mean RVGCS was -15.8% in the abnormal RVEF group versus -16.1% in normal RVEF group (p=0.25). When compared to normal controls, the difference in mean RVGLS (-16.5% vs -20.3%; p< 0.01) and RVGCS (-15.8% vs 19.9%; p< 0.01) were statistically significant.

Conclusion: The data suggests a significant association of global LV and RV strain abnormalities in post-COVID-19 patients versus healthy cohorts. This data helps guide treatment strategies in patients who may have occult uni/biventricular abnormal strains prior to a detectable decline in EF.