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D’Andrea A, Cante L, Palermi S, Carbone A, Ilardi F, Sabatella F, Crescibene F, Di Maio M, Giallauria F, Messalli G, Russo V, Bossone E. COVID-19 Myocarditis: Prognostic Role of Bedside Speckle-Tracking Echocardiography and Association with Total Scar Burden. Int J Environ Res Public Health 2022; 19:ijerph19105898. [PMID: 35627438 PMCID: PMC9140431 DOI: 10.3390/ijerph19105898] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 12/30/2022]
Abstract
SARS-CoV2 infection, responsible for the COVID-19 disease, can determine cardiac as well as respiratory injury. In COVID patients, viral myocarditis can represent an important cause of myocardial damage. Clinical presentation of myocarditis is heterogeneous. Furthermore, the full diagnostic algorithm can be hindered by logistical difficulties related to the transportation of COVID-19 patients in a critical condition to the radiology department. Our aim was to study longitudinal systolic cardiac function in patients with COVID-19-related myocarditis with echocardiography and to compare these findings with cardiac magnetic resonance (CMR) results. Patients with confirmed acute myocarditis and age- and gender-matched healthy controls were enrolled. Both patients with COVID-19-related myocarditis and healthy controls underwent standard transthoracic echocardiography and speckle-tracking analysis at the moment of admission and after 6 months of follow-up. The data of 55 patients with myocarditis (mean age 46.4 ± 15.3, 70% males) and 55 healthy subjects were analyzed. The myocarditis group showed a significantly reduced global longitudinal strain (GLS) and sub-epicardial strain, compared to the control (p < 0.001). We found a positive correlation (r = 0.65, p < 0.0001) between total scar burden (TSB) on CMR and LV GLS. After 6 months of follow-up, GLS showed marked improvements in myocarditis patients on optimal medical therapy (p < 0.01). Furthermore, we showed a strong association between baseline GLS, left ventricular ejection fraction (LVEF) and TSB with LVEF at 6 months of follow-up. After a multivariable linear regression analysis, baseline GLS, LVEF and TSB were independent predictors of a functional outcome at follow-up (p < 0.0001). Cardiac function and myocardial longitudinal deformation, assessed by echocardiography, are associated with TSB at CMR and have a predictive value of functional recovery in the follow-up.
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Affiliation(s)
- Antonello D’Andrea
- Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (L.C.); (A.C.); (F.S.); (V.R.)
- Unit of Cardiology and Intensive Coronary Care, “Umberto I” Hospital, 84014 Nocera Inferiore, Italy
- Correspondence: ; Tel.: +39-0819213377
| | - Luigi Cante
- Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (L.C.); (A.C.); (F.S.); (V.R.)
| | - Stefano Palermi
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;
| | - Andreina Carbone
- Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (L.C.); (A.C.); (F.S.); (V.R.)
| | - Federica Ilardi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.I.); (F.G.)
| | - Francesco Sabatella
- Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (L.C.); (A.C.); (F.S.); (V.R.)
| | - Fabio Crescibene
- Unit of Cardiology, Scafati M. Scarlato COVID Hospital (ASL Salerno), 84018 Scafati, Italy;
| | - Marco Di Maio
- Unit of Cardiology, Eboli Hospital (ASL Salerno), 84025 Eboli, Italy;
| | - Francesco Giallauria
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (F.I.); (F.G.)
| | | | - Vincenzo Russo
- Unit of Cardiology, Department of Traslational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (L.C.); (A.C.); (F.S.); (V.R.)
| | - Eduardo Bossone
- Cardiac Rehabilitation Unit, Cardarelli Hospital, 80131 Naples, Italy;
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D'Andrea A, Russo V, Manzo G, Giordano V, Di Maio M, Crescibene F, D'Alto M, Bossone E. Association of atrial fibrillation and left atrial volume index with mortality in patients with COVID-19 pneumonia. Eur J Prev Cardiol 2020; 29:e44-e46. [PMID: 33624089 PMCID: PMC7799107 DOI: 10.1093/eurjpc/zwaa138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/28/2020] [Accepted: 11/16/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Antonello D'Andrea
- Department of Cardiology and intensive coronary unit, "Umberto I" Hospital, Viale S. Francesco 84014 Nocera Inferiore (Salern).,Department of Cardiology, University of Campania "Luigi Vanvitelli", Monaldi Hospital -Via Bianchi - 80100 Naples, Italy
| | - Vincenzo Russo
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Monaldi Hospital -Via Bianchi - 80100 Naples, Italy
| | - Gianluca Manzo
- Department of Cardiology and intensive coronary unit, "Umberto I" Hospital, Viale S. Francesco 84014 Nocera Inferiore (Salern)
| | - Valerio Giordano
- Department of Cardiology and intensive coronary unit, "Umberto I" Hospital, Viale S. Francesco 84014 Nocera Inferiore (Salern)
| | - Marco Di Maio
- Division of Cardiology - Maria SS. Addolorata Hospital - Piazza Scuola Medica Salernitana - 84025- Eboli (Salern)
| | - Fabio Crescibene
- Division of Cardiology, M. Scarlato COVID Hospital, Via Passanti 84018 -Scafati (Salern)
| | - Michele D'Alto
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Monaldi Hospital -Via Bianchi - 80100 Naples, Italy
| | - Eduardo Bossone
- Division of Cardiology, Cardarelli Hospital, Via Cardarelli 80131 Naples
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D'Andrea A, Radmilovic J, Carbone A, Forni A, Tagliamonte E, Riegler L, Liccardo B, Crescibene F, Sirignano C, Esposito G, Bossone E. Multimodality imaging in COVID-19 patients: A key role from diagnosis to prognosis. World J Radiol 2020; 12:261-271. [PMID: 33362917 PMCID: PMC7745467 DOI: 10.4329/wjr.v12.i11.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023] Open
Abstract
The integrated clinical, laboratory and ultrasound approach is essential for the diagnosis, evaluation and monitoring of the patient's therapy in coronavirus disease 2019 pneumonia. The ideal imaging approach in this context is not yet well defined. Chest X-ray is characterized by low sensitivity in identifying earlier lung changes. The "bedside" pulmonary ultrasound has an undeniable series of advantages in the patient at high infectious risk and can provide incremental data in the respiratory intensive care for the serial control of the individual patient as well as for the home delivery of the stabilized subjects. Pulmonary computed tomography shows high sensitivity but should not be routinely performed in all patients, because in the first 48 h it can be absolutely negative and in the late phase the imaging findings may not change the therapeutic approach. Echocardiography should be limited to patients with hemodynamic instability to assess ventricular function and pulmonary pressures.
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Affiliation(s)
- Antonello D'Andrea
- Department of Cardiology, Chair of Cardiology–Luigi Vanvitelli University–Monaldi Hospital-Association of Operating Room Nurses Ospedali Dei Colli–Naples, Naples 80131, Italy
| | - Juri Radmilovic
- Department of Cardiology and Intensive Coronary Unit, “Umberto I” Hospital, Nocera Inferiore 84014, Salerno, Italy
| | - Andreina Carbone
- Department of Cardiology, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples 80131, Italy
| | - Alberto Forni
- Department of Cardiology and Intensive Coronary Unit, “Umberto I” Hospital, Nocera Inferiore 84014, Salerno, Italy
| | - Ercole Tagliamonte
- Department of Cardiology and Intensive Coronary Unit, “Umberto I” Hospital, Nocera Inferiore 84014, Salerno, Italy
| | - Lucia Riegler
- Department of Cardiology and Intensive Coronary Unit, “Umberto I” Hospital, Nocera Inferiore 84014, Salerno, Italy
| | - Biagio Liccardo
- Department of Cardiology, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples 80131, Italy
| | - Fabio Crescibene
- M. Scarlato COVID Hospital, Scafati Hospital, Scafati 84018, Italy
| | - Cesare Sirignano
- Institute of Biostructures and Bioimaging of National Research Council, National research Council, Naples 80145, Italy
| | - Giovanna Esposito
- Department of Cardiology and Intensive Coronary Unit, “Umberto I” Hospital, Nocera Inferiore 84014, Salerno, Italy
| | - Eduardo Bossone
- Division of Cardiology, Cardarelli Hospital, Naples 80131, Italy
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D'Andrea A, Scarafile R, Riegler L, Liccardo B, Crescibene F, Cocchia R, Bossone E. Right Ventricular Function and Pulmonary Pressures as Independent Predictors of Survival in Patients With COVID-19 Pneumonia. JACC Cardiovasc Imaging 2020; 13:2467-2468. [PMID: 32654965 PMCID: PMC7314435 DOI: 10.1016/j.jcmg.2020.06.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023]
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Pacileo M, Giallauria F, Savarese C, Cirillo T, Crescibene F, Di Lorenzo A, Ferrillo M, Calabrese MG, Vigorito C, D'Andrea A. The role of echocardiography in SARS-CoV-2 pandemic: a compromise among appropriateness, safety and clinical impact. Monaldi Arch Chest Dis 2020; 90. [PMID: 32425014 DOI: 10.4081/monaldi.2020.1358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/13/2020] [Indexed: 11/22/2022] Open
Abstract
SARS-CoV-2 infection, responsible for COVID-19, can determine cardiac events, which require a quick diagnosis and management, and should not be overlooked due to the presence of COVID-19 infection. In some cases, cardiovascular symptoms can also be the first and only manifestation of SARS-CoV-2 infection. In patients with COVID-19, the full cardiovascular disease diagnostic algorithm can be hindered by logistic restrain mainly derived from the difficulty of transporting patients in critical conditions to Radiology or Hemodynamics wards. The echocardiography in SARS-CoV-2 pandemic can help for differential diagnosis of cardiac events, which can be related or unrelated by the infection and can likely impact on short-term prognosis. Indeed, transthoracic echocardiography plays a key role in the screen for CV complications of COVID-19 infection: it must be focused cardiac ultrasound study (FoCUS) performed at bedside. All transthoracic, transesophageal and stress echocardiograms in patients in which test results are unlikely to change the management strategy should be postponed.
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Affiliation(s)
- Mario Pacileo
- Division of Cardiology, Hospital Umberto I, Nocera Inferiore (SA).
| | | | | | - Teresa Cirillo
- Division of Cardiology, Hospital Umberto I, Nocera Inferiore (SA).
| | - Fabio Crescibene
- Division of Cardiology, COVID Hospital M. Scarlato, Scafati (SA).
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, Federico II University of Naples.
| | | | | | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University of Naples.
| | - Antonello D'Andrea
- Division of Cardiology, Hospital Umberto I, Nocera Inferiore (SA); Division of Cardiology, University of Campania L. Vanvitelli, Naples.
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