Alsagaff, M.Y.; Wardhani, L.F.K.; Nugraha, R.A.; Putra, T.S.; Khrisna, B.P.D.; Al-Farabi, M.J.; Gunadi, R.I.; Azmi, Y.; Budianto, C.P.; Fagi, R.A.; Luthfah, N.; Subagjo, A.; Oktaviono, Y.H.; Lefi, A.; Dharmadjati, B.B.; Alkaff, F.F.; Pikir, B.S. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J. Clin. Med.2024, 13, 352.
Alsagaff, M.Y.; Wardhani, L.F.K.; Nugraha, R.A.; Putra, T.S.; Khrisna, B.P.D.; Al-Farabi, M.J.; Gunadi, R.I.; Azmi, Y.; Budianto, C.P.; Fagi, R.A.; Luthfah, N.; Subagjo, A.; Oktaviono, Y.H.; Lefi, A.; Dharmadjati, B.B.; Alkaff, F.F.; Pikir, B.S. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J. Clin. Med. 2024, 13, 352.
Alsagaff, M.Y.; Wardhani, L.F.K.; Nugraha, R.A.; Putra, T.S.; Khrisna, B.P.D.; Al-Farabi, M.J.; Gunadi, R.I.; Azmi, Y.; Budianto, C.P.; Fagi, R.A.; Luthfah, N.; Subagjo, A.; Oktaviono, Y.H.; Lefi, A.; Dharmadjati, B.B.; Alkaff, F.F.; Pikir, B.S. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J. Clin. Med.2024, 13, 352.
Alsagaff, M.Y.; Wardhani, L.F.K.; Nugraha, R.A.; Putra, T.S.; Khrisna, B.P.D.; Al-Farabi, M.J.; Gunadi, R.I.; Azmi, Y.; Budianto, C.P.; Fagi, R.A.; Luthfah, N.; Subagjo, A.; Oktaviono, Y.H.; Lefi, A.; Dharmadjati, B.B.; Alkaff, F.F.; Pikir, B.S. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J. Clin. Med. 2024, 13, 352.
Abstract
Myocardial involvement among critical patients with coronavirus disease 2019 (COVID-19) has a worse outcome. The occurrence of an imbalance in oxygen supply results in the release of pro-inflammatory cytokines which leads to increased ventilation support requirement and increase risk of mortality. Our aim was to evaluate the association between hs-Troponin I level and global longitudinal strain as evidence of myocardial involvement among critical COVID-19 patients. Methods. We performed prospective cohort study from February 1st – July 31st, 2021 at Dr. Soetomo General Hospital, Surabaya as referral center for COVID-19 care. Of the 65 critical COVID-19 included, 41 (63.1%) were men, with a median (interquartile range) age of 51.0 years (20.0-75.0).Subjects were recruited according to WHO criteria for severe COVID-19 and CDC criteria for myocarditis. All subjects recruited were examined using echocardiography to measure global longitudinal strain (GLS) and blood samples were taken to measure hs-Troponin. Subjects were then followed to assess their needs for mechanical ventilation and in-hospital mortality. Severe COVID-19 subjects with cardiac injury were associated with an increased need for intubation (78.5%) and an increased incidence of myocarditis (50.8%). There was an association between the use of intubation and the risk of mortality in patients (66.7% vs. 33.3%, p-value <0.001). Both reduced GLS and increased hs-troponin are associated with increased myocarditis (p-value <0.001 and 0.004 respectively). Reduced GLS is associated with higher mechanical ventilation needs (12.17 + 4.79 vs.15.65 + 4.90, p-value 0.02) and a higher mortality rate (11.36 + 4.64 vs. 14.74 + 4.82; p-value 0.005). Increased hs-troponin is associated with higher mechanical ventilation needs (25.33% vs. 3.56%, p-value 0.002) and a higher mortality rate (34.57% vs. 5.76%, p-value 0.002). Compared with contemporary controls, critical COVID-19 patients with myocardial involvement and elevated cardiac troponin level are associated with higher mechanical ventilation needs and a higher mortality rate.
Keywords
COVID-19; hs-Troponin; global longitudinal strain; intubation; myocarditis
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
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