JAHA:COVID-19住院3个月后的心脏功能障碍和心律失常负担

2022-01-24 MedSci原创 MedSci原创

COVID-19出院3个月后,右心室功能轻度受损,舒张功能障碍的发生率是对照组的两倍。几乎没有证据表明心脏功能与重症监护治疗、呼吸困难或疲劳之间存在关联。

COVID-19后心功能不全的严重程度各不相同,并且缺乏关于心律失常负担的数据。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,这是一项联合多中心前瞻性队列研究和横断面病例对照研究。研究人员将出院后3至4个月的COVID-19患者通过超声心动图评估的心脏功能并与匹配的对照组进行比较。

研究人员记录了COVID-19患者的24小时心电图数据。该研究共有204名COVID-19患者同意参与试验(平均年龄为58.5岁;44%为女性),以及204名对照者(平均年龄为58.4岁;44%为女性)。

与对照组相比,COVID-19患者右心室游离壁纵向应变更严重(调整后的估计平均差为1.5个百分点;95%CI为-2.6至-0.5;P=0.005)和三尖瓣环平面收缩期偏移(-0.10cm;95%CI为-0.14至-0.05;P<0.001)和心脏指数(-0.26L/min/m2;95%CI为-0.40至-0.12;P<0.001)较低,但左心室整体应变稍好(-0.8个百分点;95%CI为0.2-1.3;P=0.008)。与对照组相比,舒张功能下降的发生率是对照组的两倍(分别为60[30%] vs. 29[15%];比值比为2.4;P=0.001)。呼吸困难或疲劳与心脏功能无关。重症监护治疗后右心室游离壁纵向应变更严重。27%的患者出现心律失常,主要包括室性早搏和非持续性室性心动过速(分别为18%和5%)。

由此可见,COVID-19出院3个月后,右心室功能轻度受损,舒张功能障碍的发生率是对照组的两倍。几乎没有证据表明心脏功能与重症监护治疗、呼吸困难或疲劳之间存在关联。室性心律失常很常见,但其临床重要性尚未明确。

原始出处:

Charlotte B. Ingul.et al.Cardiac Dysfunction and Arrhythmias 3 Months After Hospitalization for COVID‐19.JAHA.2022.https://www.ahajournals.org/doi/full/10.1161/JAHA.121.023473

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    2022-05-03 maotouying

    很不错的研究发现,学习了,非常感谢

    0

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    2022-01-22 zhaohui6731
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