心脏受累是COVID-19后无肺后遗症患者持续呼吸困难的原因:一项回顾性研究

Tuğçe Çöllüoğlu, M. Acat, Ömer Özsaraç, Y. Akin, O. Önalan
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摘要

目的:在急性冠状病毒病-2019 (COVID-19)感染中,已经描述了几种形式的心血管疾病,并且已经表明急性感染是心脏症状的原因。然而,慢性期心脏受累和相关症状的数据尚不清楚。最近的证据表明,COVID-19感染后持续呼吸困难的原因可能是持续的心功能障碍。本研究的目的是探讨无肺后遗症的COVID-19后患者持续呼吸困难与心脏受累之间的关系。材料和方法:在我们的研究中,我们招募了30名在2021年1月至2021年7月期间出现呼吸困难的COVID-19后患者。在所有患者中,PFT和胸部CT检查均未发现肺部后遗症。分别行2D-TTE、2D-STE、MPS检查。结果:随访3个月,63.3%的患者出现左室功能不全,93.3%的患者出现广泛的GLS异常。33.3%的患者存在心肌灌注缺损(MPD), MPD均为可逆性缺损。MPD明显见于前壁(60%)和中节段(20%)至根尖节段(70%)。与无MPD患者相比,MPD患者的CK-MB (p: 0.016)和肌钙蛋白I (p: 0.011)较高,PW厚度较小(p:0.020), A2C位收缩应变率峰值较低(p:0.031)。NYHA III组患者GLS受损程度高于NYHA II组(p:0.035)。结论:我们的研究表明,在COVID- 19后无肺后遗症的患者中,缺血性或非缺血性心功能障碍可能与持续呼吸困难有关。Turkiye Klinikleri版权所有©2022。
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Cardiac Involvement is the Reason for Persistent Dyspnea in Post COVID-19 Patients without Pulmonary Sequelae: A Retrospective Study
Objective: Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019 (COVID-19) infection and also it has been shown that acute infection is responsible for cardiac symptoms. However, the data on cardiac involvement and associated symptoms in chronic phase remains unclear. Recent evidence have shown that the reason for persistent dyspnea can be persistent cardiac dysfunction in post COVID-19 infection. The aim of our study was to investigate the relationship between persistent dyspnea and cardiac involvement in post COVID-19 patients without pulmonary sequelae. Material(s) and Method(s): In our study, we recruited 30 post COVID-19 patients with dyspnea between January 2021 and July 2021. In all patients, the absence of pulmonary sequelae was detected with PFT and chest- CT. 2D-TTE, 2D-STE and MPS were performed for each case. Result(s): Left ventricular dysfunction was detected in 63.3% of patients and also 93.3% of patients had extensive abnormal GLS at 3 month follow-up. Of the patients, 33.3% had myocardial perfusion defect (MPD) and all MPDs were observed to be reversible defects. MPD was obviously seen in anterior wall (60%) and mid (20%) to apical (70%) segments. As compared with patients without MPD, patients with MPD had higher CK-MB (p: 0.016) and troponin I (p: 0.011), lesser PW thickness (p:0.020) and lower peak systolic strain rate at A2C view (p:0.031). Patients with NYHA III had more impaired GLS than patients with NYHA II (p:0.035). Conclusion(s): Our study suggests ischemic or non-ischemic cardiac dysfunction may be associated with persistent dyspnea in post- COVID- 19 patients without lung sequelae. Copyright © 2022 by Turkiye Klinikleri.
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Turkiye Klinikleri Cardiovascular Sciences
Turkiye Klinikleri Cardiovascular Sciences Medicine-Cardiology and Cardiovascular Medicine
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