ABSTRACT
Objective: COVID-19 pandemic has a rather negative effect on patients with cardiovascular pathology. AH is one of the main reasons for the remodeling process in AF patients and makes a significant contribution to the development of heart structural changes. The aim of this study is to identify the feature of AF occurrence and progression in patients with AH, who have undergone COVID-19. Design and method: In this study where enrolled 91 patients with AH and nonvalvular paroxysmal/persistent AF, who have undergone COVID-19 (first group). As a control group 109 patients with AH and AF, but without have undergone COVID- 19 were also examined (second group). The database consisting of indices that characterize the clinical, hemodynamic and structural-functional state of the heart, were analyzed by SPSS 13. Results: The obtained results showed that in the first group patients were signifi- cantly older than in the second group (mean age 71.6 ± 7.4 vs. 61.6 ± 6.4 years, p < 0.001). Resting heart rate was significantly higher in patients from first group in comparison with second group (86.6 ± 6.2 vs. 76.9 ± 7.8 beat/min, p < 0.01). In first group body mass index of patients was significantly more than in second group (33.9 ± 1.5 vs. 31.6 ± 1.8 kg/m2, p < 0.05). In the first group the prevalence of patients with uncontrolled AH were statistically significantly higher, than in the second group (54% vs. 23%, p < 0.001). In those patients the doses of antihypertensive medications taken were either increased or the antihypertensive treatment were revised. Moreover, in the first group the frequency of hypertensive crises was nearly twofold higher (31% vs. 17%, p < 0.001). It was revealed that the left atrium diameter in patients of the first group was significantly greater than in the second (44.3 ± 1.4 vs.41.2 ± 1.1 mm, p < 0.05);but systolic and diastolic dysfunction did not significantly differ in both groups. Conclusions: The obtained results indicate that in patients with AH who have undergone COVID-19, the onset of AF has some features, namely;uncontrolled AH, frequent hypertensive crises, tachycardia, overweight and older age. As well as left atrium more large dilation compared with second group that did not undergo a viral infection.
ABSTRACT
COVID-19 pandemic has a rather negative effect on patients with cardiovascular pathology, also in patients without cardiovascular disease because its pathogenesis is based on generalized vascuities of the microvasculature with the development of multiple thrombosis and thromboembolism. Atrial fibrillation (AF) is one of the major cardiac arrhythmias and accounts for almost one third of all arrhythmias. Changes in electrical, structural, and contractile properties of cardiac tissue that are thought to underlie AF maintenance and progression are reviewed. The aim of this study is to identify the features and predictors that contribute to the onset or development of AF in patients who have had COVID -19. Methods: This was a three-center prospective study, conducted in the coronary care unit during the period of February 2020 to June 2021. This study included 196 patients with AF who underwent COVID-19 at different times of this period (I group). For comparison, the data of similar 203 AF patients without COVID (II group) were analyzed in the period from February 2018 to February 2019 from the same centers. Medical history, clinical, instrumental and laboratory data, including troponin-1, tissue factor (TF), and hsCRP were studied in all patients. The data obtained was analyzed for statistical significance including multivariable logistic regression using analyses by SPSS 16. Results: The compared results showed that the first-onset AF in patients from first group was observed in 18.7% compared with 8.1% in second group. In intensive care units, AF were registered in 44.2% of patients in I group vs. 7.1% of patients in II group. In first group among patients with ACS, AF occurred in 12.7% of cases vs. similar patients in II group- 8.4%. In first group hypokalemia was observed in 67.8% of cases vs. 28.6% in II group. Multivariable logistic regression was shown that among tested biomarkers, hsCRP , troponin-I and TF were more higher in patients undergoing COVID in compared patients with AF without COVID (odds ratio, 3.48;p<0.001, 2.36 p<0.017 and 2.48 p<0.01 accordingly). Conclusions: Some features of the onset or development of AF were identified in patients undergoing COVID. So, In these patients compared with AF patients without COVID, AF more often occurs in clinically severe patients, with ACS, as well as in patients with severe hypokalemia, higher hsCRP, TF and troponin values.
ABSTRACT
COVID-19 pandemic is a global public health burden, which has a rather negative effect on patients with cardiovascular pathology, especially with ischemic heart disease. The aim of this study is to identify predictors that contribute to the onset or development of ACS in patients who have had COVID-19 Methods: This was a three-center prospective study, conducted in the coronary care unit of two medical centers and the Institute of Cardiology in Armenia during the period of February 2020 to February 2021. This study included 393 patients with acute coronary syndrome (ACS) patients who underwent COVID-19 at different times of this period (I group). For comparison, the data of similar 297 patients were analyzed in the period from February 2018 to February 2019 from the same centers without COVD (II group). Admissions were classified as ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), or other ACS (including unstable angina). Medical history, clinical, instrumental and laboratory data were studied in all patients. The data obtained was analyzed for statistical significance using multivariate analyses by SPSS 16. Results: The compared results showed that the number of I group patients with NSTEMI was significantly higher than in the second group (67% vs 49%). The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular fibrillation) also increased in first group. Atrial fibrillation (AF) in I group was detected in 12.7% of cases, especially in those patients who have had lung damage and accompanied by more severe hemodynamic disorders. In II group AF was detected in 8.1% cases. Patients have a history of arterial hypertension (AH) and diabetes (D) in I group patients were detected in 79.3% and 28.3% of cases respectively, and in II group in 67.8% and 21.2% cases. Heart failure (HF) occurred in 1 group more often than in II group patients (47% vs 34%). In I group the age of patients was significantly higher than in group II (73±8.6 vs. 69±9.9 p<0.013). Analysis of coronary angiography data showed that, multivessel coronary vessels in I group patients was observed more often than in second group (16.8% vs 7.9%). Conclusions: The results of the present study revealed that older age, AH, diabetes and HF are predictors of ACS in patients with COVID-19. These patients more often develop NSTEMI and are characterized by multivessel coronary artery disease. Among the complications, heart rhythm disturbances, especially AF, are more common.