A Prospective Study on Post-Viral Cardiac Remodeling in Young Adults Recovering from Dengue Infection

Abstract

Dengue infection is a virus that is spreading very fast among the world in terms of the number of cases, and although the acute symptoms of the condition were well characterized, the chronic cardiac effects are barely known. Recent studies indicate that dengue has the possibility of causing subclinical myocardial inflammation, autonomic imbalance, and structural remodelling which may extend beyond the acute. This is a prospective study that attempts to assess patterns of cardiac remodeling in young adults (1830 years old) after laboratory-confirmed dengue infection. One hundred and twenty individuals were continued during 12 weeks after recovery and administered to serial measurements comprising echocardiography, electrocardiography, cardiac biomarkers (troponin-I, NT-proBNP), and heart rate variability. The findings showed that 28% of the participants had temporary left ventricular (LV) diastolic dysfunction and 16% of the subjects presented with continuing low global longitudinal strain measures. Echocardiographic abnormalities were associated with the increased levels of biomarkers, indicating that myocardial stress is still present. Even though the majority of changes were resolved by week 12, some of them revealed delicate but consistent deviations of structures and functions, which are typical of early remodeling. These results indicate that dengue should be considered as a possible cause of post-viral cardiac sequelae, particularly in younger populations that used to be regarded as low-risk of cardiovascular complications. Follow up imaging, early screening and risk-stratified management could be used to prevent the development of long-term dysfunction. The research suggests that further research should be conducted using larger multi-centered longitudinal studies to confirm these early results and identify the mechanisms.