In a new study from Johns Hopkins Medicine, researchers found that a type of echocardiogram, a common test to evaluate whether a person’s heart is pumping properly, may be useful in predicting which patients with COVID-19 are most at risk of developing atrial fibrillation.
Atrial fibrillation is an irregular heartbeat that can increase a person’s risk for heart failure and stroke, among other heart issues.
The findings also suggest that patients with COVID-19 who go on to develop atrial fibrillation more commonly have elevated levels of heart-related proteins.
If further studies confirm the findings, this could lead to new therapies to prevent strokes and heart attacks in certain COVID-19 patients who are at the highest risk.
Previous studies have found that patients who are hospitalized with COVID-19 have more than double the rate of arrhythmias, including atrial fibrillation and atrial flutter, a similar rapid rhythm that can lead to heart failure and stroke.
But exactly how the virus causes these heart complications, and who is most at risk of developing atrial fibrillation because of COVID-19, has been poorly understood.
In this study, the team compared 80 patients with COVID-19 with 34 patients who did not have COVID-19 who were also treated in the intensive or intermediate care units for respiratory issues. None of the patients had a history of heart arrhythmia.
The team found that, overall, patients with COVID-19 had reduced function of their left atrium, the chamber of the heart that receives oxygenated blood from the lungs.
Left atrial strain—a measure of the movement of the left atrium’s walls—was much lower in patients with COVID-19 and left atrial emptying fraction—a measure of how much blood the atrium empties with each contraction—was also lower in the patients with COVID-19.
Moreover, left atrial strain was even lower among the 30% of patients with COVID-19 who developed atrial fibrillation or flutter during their hospital stay compared with other patients with COVID-19.
This suggests that speckle-tracking analysis—and specifically, left atrial strain measurement.
The team says a lot of patients already get echocardiograms while in the hospital; the addition of strain analysis requires no extra scanning of the patient.
So this is a safe and affordable new data point that can clue doctors in about who might develop atrial fibrillation.
Echocardiograms cost on average about $2,000, and are generally covered by health insurance.
The study is published in the Journal of the American Society of Echocardiography. One author of the study is Allison Hays, M.D.
