Right Ventricular Strain in Post-COVID Syndrome: Functional Recovery Does Not Always Mean Myocardial Recovery

Among the various cardiovascular manifestations of post-COVID-19 syndrome, few remain as challenging as interpreting the persistent alterations in right ventricular mechanics. Although numerous studies have shown that the right ventricle is particularly susceptible to the overload imposed by the pulmonary circulation during the acute phase of infection, the clinical significance of the echocardiographic abnormalities that persist after recovery is still incompletely understood.

Its high sensitivity to variations in pulmonary afterload, hypoxia, vascular inflammation, and microvascular thrombosis explains the vulnerability of the right ventricle to SARS-CoV-2. This fact justifies the growing interest in the right ventricular free-wall longitudinal strain (RVFWLS), currently recognized as the most sensitive echocardiographic method for detecting subclinical impairment of right ventricular function before changes appear in conventional parameters.^,

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