Comparison of biventricular myocardial strain according to treatment regimens in patients discharged after COVID-19 recovery

Pelin Karaca Özer; Elif Ayduk Govdelı; Mustafa Altınkaynak; Derya Baykız; Huzeyfe Arıcı; Yunus Çatma; Alpay Medetalibeyoğlu; Ekrem Bilal Karaayvaz

doi:10.17826/cumj.1092998

TR EN

COVID-19'dan iyileşme sonrası tedavi rejimlerine göre biventriküler miyokard geriliminin karşılaştırılması

Öz

Amaç: COVID-19' da farklı terapötik stratejiler uygulanmıştır ve bu stratejilerin kardiyak fonksiyon üzerindeki etkisi belirsizdir. Çalışmanın amacı, COVID-19' dan iyileşen hastalarda farklı tıbbi tedavilerin biventriküler fonksiyon üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntem: COVID-19'dan iyileştikten sonra takip ziyaretlerinde hastaların biventriküler miyokardiyal işlevini incelemek için benek izleme ekokardiyografisi yapıldı. Hastaların aktif hastalık sırasında kullandığı medikasyonlar retrospektif olarak öğrenildi ve favipiravir (FAV, n=60) ve hidroksiklorokin (HCQ, n=60) alanlar olmak üzere iki gruba ayrıldı. Risk faktörü uyumlu kontroller (n=41) ile bir karşılaştırma yapıldı. Bulgular: Toplam 161 hasta çalışmaya dahil edildi. Sol ventrikül diyastol sonu hacmi, sistol sonu hacmi, diyastol sonu çapı ve sistol sonu çapı HCQ ve FAV gruplarında kontrollere göre daha yüksekti, ancak gruplar arasında sol ventrikül ejeksiyon fraksiyonu benzerdi. Kontrollere göre HCQ ve FAV gruplarında sağ ventrikül çapı artmış ve sistolik pulmoner arter basıncı daha yüksekti. HCQ grubunda, FAV ve kontrol grupları ile karşılaştırıldığında, sol ventrikül global uzunlamasına gerilim (%-18±6,6; %-19,7±4,4; %-20,4±5; sırasıyla), sağ ventrikül global uzunlamasına gerilim (%-19,8±7,5; %-22,2±6; %-23,4±6,2; sırasıyla) ve sağ ventrikül serbest duvar gerilimi (%-16,9±3,6; %-18,2±2,4; %-19,6±4,7; sırasıyla) daha kötüydü. Sonuç: Çalışmamızdaki mevcut sonuçlara dayanarak, hem HCQ hem de FAV gruplarında kontrollere kıyasla subklinik kardiyak etkilenmenin ekokardiyografik kanıtları vardır. Bununla birlikte, HCQ tedavisi, FAV ile karşılaştırıldığında COVID-19'dan kurtulanlarda biventriküler subklinik sistolik disfonksiyon riskinde artış ile ilişkilendirilmiştir.

Anahtar Kelimeler

COVID-19 , iyileşme , favipiravir , hidroksiklorokin , benek izleme ekokardiyografi.

Comparison of biventricular myocardial strain according to treatment regimens in patients discharged after COVID-19 recovery

Abstract

Purpose: The effects of different COVID-19 therapeutic strategies on cardiac function are uncertain. Therefore, this study aimed to evaluate the effects of different medical treatments on biventricular function in patients who had recovered from COVID-19. Materials and Methods: Speckle-tracking echocardiography was performed to examine the biventricular myocardial function of patients at follow-up visits after recovery from COVID-19. The patients were divided into two groups based on the medication they used during the active disease: favipiravir (FAV; n = 60) or hydroxychloroquine (HCQ; n = 60). A comparison was made with risk factor–matched controls (n = 41). Results: A total of 161 patients were included in the study. The left ventricular end-diastolic volume, end-systolic volume, end-diastolic diameter, and end-systolic diameter were higher in the HCQ and FAV groups compared to the controls, while the left ventricular ejection fraction was similar between all the groups. The right ventricular diameter was increased, and the systolic pulmonary artery pressure was higher in the HCQ and FAV groups compared to the controls. The left ventricular global longitudinal strain (-18±6.6 vs. -19.7±4.4 vs. -20.4±5, respectively), the right ventricular global longitudinal strain (-19.8±7.5 vs. -22.2±6 vs. -23.4±6.2, respectively), and the right ventricular free wall strain (-16.9±3.6 vs. -18.2±2.4 vs. -19.6±4.7, respectively) were worse in the HCQ group compared to the FAV and control groups. Conclusion: This study found echocardiographic evidence of subclinical cardiac involvement in both the HCQ and FAV groups compared to the controls. However, HCQ treatment was associated with an increased risk of biventricular subclinical systolic dysfunction in COVID-19 survivors compared with FAV treatment.

Keywords

COVID-19 , recovery , favipiravir , hydroxychloroquine , speckle tracking echocardiography

Kaynakça

1. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273.
2. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60.
3. Song Y, Zhang M, Yin L, Wang K, Zhou Y, Zhou M, et al. COVID-19 treatment: close to a cure? A rapid review of pharmacotherapies for the novel coronavirus (SARS-CoV-2). Int J Antimicrob Agents. 2020 Aug;56(2):106080.
4. Clinical management of COVID-19 https://www.who.int/publications-detail redirect/clinical-management-of-covid-19 (Accessed 24 June 2020).
5. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study. Engineering (Beijing). 2020;6(10):1192-1198.
6. Prakash A, Singh H, Kaur H, Semwal A, Sarma P, Bhattacharyya A, et al. Systematic review and meta-analysis of effectiveness and safety of favipiravir in the management of novel coronavirus (COVID-19) patients. Indian J Pharmacol. 2020;52(5):414-421.
7. Ivashchenko AA, Dmitriev KA, Vostokova NV, Azarova VN, Blinow AA, Egorova AN, et al. AVIFAVIR for Treatment of Patients with Moderate COVID-19: Interim Results of a Phase II/III Multicenter Randomized Clinical Trial. Clin Infect Dis. 2020;9:ciaa1176.
8. Blessberger H, Binder T. NON-invasive imaging: Two dimensional speckle tracking echocardiography: basic principles. Heart. 2010;96(9):716-22.
9. Rothschild E, Baruch G, Szekely Y, Lichter Y, Kaplan A, Taieb P, et al. The Predictive Role of Left and Right Ventricular Speckle-Tracking Echocardiography in COVID-19. JACC Cardiovasc Imaging. 2020;13(11):2471-2474.
10. Baycan OF, Barman HA, Atici A, Tatlisu A, Bolen F, Ergen P, et al. Evaluation of biventricular function in patients with COVID-19 using speckle tracking echocardiography. Int J Cardiovasc Imaging. 2021;37(1):135-144.

11. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, et al. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019 ;32(1):1-64.
12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14.
13. Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, Derumeaux G, et al. Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. J Am Soc Echocardiogr. 2011;24(3):277-313.
14. McFee DRB. COVID-19 medical management including World Health Organization (WHO) suggested management strategies. Dis Mon. 2020;66(9):101068.
15. Fiolet T, Guihur A, Rebeaud ME, Mulot M, Peiffer-Smadja N, Mahamat-Saleh Y. Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(1):19-27.
16. Hong TS, Gonzalez J, Nahass RG, Brunetti L. Impact of Hydroxychloroquine on Mortality in Hospitalized Patients with COVID-19: Systematic Review and Meta-Analysis. Pharmacy (Basel). 2020;5;8(4):208.
17. Peters EJ, Collard D, Van Assen S, Beudel M, Bomers MK, Buijs J, et al. CovidPredict Study Group. Outcomes of persons with coronavirus disease 2019 in hospitals with and without standard treatment with (hydroxy)chloroquine. Clin Microbiol Infect. 2021;27(2):264-268.
18. Dabbous HM, Abd-Elsalam S, El-Sayed MH, Sherief AF, Ebeid FFS, El Ghafar MSA, et al. Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study. Arch Virol. 2021;166(3):949-954.
19. Udwadia ZF, Singh P, Barkate H, Patil S, Rangwala S, Pendse A, et al. Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial. Int J Infect Dis. 2021;103:62-71.
20. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020;1;5(7):802-810.
21. Repessé X, Charron C, Vieillard-Baron A. Right ventricular failure in acute lung injury and acute respiratory distress syndrome. Minerva Anestesiol. 2012;78(8):941-8.
22. Ozer PK, Govdeli EA, Baykiz D, Karaayvaz EB, Medetalibeyoglu A, Catma Y, et al. Impairment of right ventricular longitudinal strain associated with severity of pneumonia in patients recovered from COVID-19. Int J Cardiovasc Imaging. 2021;11:1–11.
23. Özer S, Candan L, Özyıldız AG, Turan OE. Evaluation of left ventricular global functions with speckle tracking echocardiography in patients recovered from COVID-19. Int J Cardiovasc Imaging. 2021;16:1–7.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Klinik Tıp Bilimleri

Bölüm

Araştırma Makalesi

Yazarlar

Pelin Karaca Özer ^*
0000-0002-1085-5462
Türkiye

Elif Ayduk Govdelı
0000-0002-6595-4812
Türkiye

Mustafa Altınkaynak
0000-0002-7768-2746
Türkiye

Derya Baykız
0000-0003-0666-6631
Türkiye

Huzeyfe Arıcı
0000-0003-4128-8533
Türkiye

Yunus Çatma
0000-0001-7306-5217
Türkiye

Alpay Medetalibeyoğlu
0000-0002-5829-9186
Türkiye

Ekrem Bilal Karaayvaz
0000-0002-0105-6167
Türkiye

Yayımlanma Tarihi

30 Eylül 2022

Gönderilme Tarihi

26 Mart 2022

Kabul Tarihi

20 Haziran 2022

Yayımlandığı Sayı

Yıl 2022 Cilt: 47 Sayı: 3

DOI

https://doi.org/10.17826/cumj.1092998

IZ

https://izlik.org/JA38CL46RY

MLA

Karaca Özer, Pelin, vd. “Comparison of biventricular myocardial strain according to treatment regimens in patients discharged after COVID-19 recovery”. Cukurova Medical Journal, c. 47, sy 3, Eylül 2022, ss. 1005-14, doi:10.17826/cumj.1092998.

Bu eser Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

COVID-19'dan iyileşme sonrası tedavi rejimlerine göre biventriküler miyokard geriliminin karşılaştırılması

Öz

Anahtar Kelimeler

Comparison of biventricular myocardial strain according to treatment regimens in patients discharged after COVID-19 recovery

Abstract

Keywords

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

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