Global Longitudinal Strain and Myocardial Work Index in Post-COVID-19 Syndrome with Mild Symptoms: A Case Series.

The involvement of the cardiovascular system in COVID-19 is prevalent. The effect of SARS-COV-2 infection in both acute and recovery phases is called a post-COVID-19 syndrome. Considering the high prevalence of cardiac abnormalities after COVID-19, clinicians should continue to monitor cardiac function in COVID-19 patients after hospital discharge. Echocardiography is an accurate and accessible tool to assess cardiac function after COVID-19. Left-ventricle (LV) and right ventricle (RV) longitudinal strains are more sensitive to detecting subtle abnormalities than standard parameters, such as left-ventricle ejection fraction and tricuspid annular plane systolic excursion (TAPSE). Myocardial work index is a novel parameter including afterload to evaluate cardiac function. These parameters can give further information on cardiac function in COVID-19 patients. We presented two cases of COVID-19 with serial cardiac assessment using echocardiography.

Impact of older age at Fontan completion on mid-term survival.

BACKGROUND: The optimum age of Fontan completion remains unknown. Currently, the majority of centers worldwide are performing Fontan completion at 2-4 years of age. In Indonesia, lack of awareness and limited resources probably explain why patients seek treatment at advanced stage. This study aimed to evaluate the impact of older age at Fontan completion on mid-term survival. RESULTS: A single-center retrospective cohort study was performed on 261 patients who underwent Fontan completion between 2008 and 2019 and survived to discharge. The patients were followed up until April 2020, with a median follow-up period of 3 years (range 0-12 years). The median age was 5 years (range 2-24 years). The survival rates of patients with the age at operation ≤ 6 years and > 6 years were 92.1% and 82.8%, respectively. A subgroup analysis showed that the survival rates for age < 4 years, 4-6 years (reference age), 6-8 years, 8-10 years, 10-18 years, and > 18 years were 85.7%, 94.8%, 85.4%, 78.8%, 85.7%, and 66.7%, respectively. Age at Fontan completion of > 6 years (HR 3.84; p = 0.020) was associated with a lower 12-year survival rate. The age at operation of 8-10 years (HR 6.79; p = 0.022) and > 18 years (HR 15.30; p = 0.006) had the worst survival rates. CONCLUSIONS: An older age at Fontan completion (> 6 years) significantly reduced mid-term survival rate. The age at Fontan of 8-10 years and > 18 years had higher risk of mid-term death than age of 4-6 years.