The Evaluation of Myocardial Performance Index in Patients with
COVID-19: An Echocardiographic Follow-up Study”
Abstract
INTRODUCTION: The epidemic of pneumonia caused by a new coronavirus
disease 2019 (COVID-19) rapidly spread all over the world.
Pathophisyology of the cardiovascular effects of COVID-19 is still not
well known. Myocardial dysfunction may occur in cytokine-based immune
reactions. Myocardial performance index (MPI) is a feasible parameter
that reflects systolic and diastolic cardiac functions. We aimed to
evaluate the MPI in patients with COVID-19. METHODS: The study consisted
of 40 patients diagnosed with COVID-19 who had mild pneumonia and did
not need intensive care treatment. All patients underwent
echocardiographic evaluation. The MPI and laboratory parameters were
compared between the acute period of infection and after clinical
recovery in patients with COVID-19. RESULTS: Statistically significant
higher MPI (0.56±0.09 versus 0.44±0.07, p<0.001), longer
isovolumic relaxation time (112.3 ±13.4 versus 91.8±12.1ms,
p<0.001), longer deceleration time (182.1 ± 30.6 versus 161.5
± 43.5ms, p=0.003), shorter ejection time (279.6±20.3 versus
298.8±36.8ms, p<0.001) and higher E/A ratio (1.53±0.7 versus
1.22±0.4, p<0.001), were observed during acute period of
infection compared to ones after clinical recovery. Compared with basal
values, no significant change in left ventricular (LV) systolic ejection
fraction was observed after clinical recovery (60.3 ± 3.2% versus
61.7±2.4%, p>0.05). CONCLUSION: Our study showed that
although, LV systolic function appear normal in COVID-19 patients, they
have globally reversible LV diastolic dysfunction, based on tissue
Doppler derived MPI. This could be due to isolated subclinical diastolic
dysfunction. The underlying mechanism and its clinical significance can
be established by further studies.