Features of intracardiac hemodynamics in patients with acute myocardial infarction with st segment elevation who underwent COVID-19

Abstract

Objective: to evaluate the features of central and intracardiac hemodynamics in patients with ST-segment elevation myocardial infarction (STEMI), who underwent COVID-19 during inpatient stay and 6 months after the development of STEMI. Materials and methods. 140 patients with STEMI were included in the study. The patients were randomized into 2 groups: I - main group - patients with STEMI who suffered COVID-19 (52 people) in the period from 1.5-6 months before the development of acute coronary syndrome (ACS), II - comparison group (88 people) which included patients with STEMI who did not have COVID-19 in the anamnesis. All patients underwent PCI with stenting of the infarct-related artery in the first 24 hours from the onset of ACS. The parameters of central and intracardiac hemodynamics in all patients were determined for 2-3 days (1st control point), 9-11 days (2nd control point), after 6 months (3rd control point) from the moment of hospitalization for STEMI. Results. In the patients of the main group of the study, more pronounced changes in the systolic-diastolic LV function were recorded on the 2-3 day of STEMI: LV EF by 8.5%, Sm by 7.2% and E' by 24.5% (p<0.05) were lower than in the control group, respectively, E/E' by 11.5% and WMSI by 21.8% (p<0.05) were higher than in the comparison group. On the 9th-11th day of the disease in patients with STEMI who underwent COVID-19, a slowdown in the recovery of the studied parameters was revealed: the LV EF value was lower than in the control group by 11%, Sm by 12% and E' by 20% (p<0.05), respectively, and the value of E/E' by 27% and WMSI by 25% (p<0.05) were higher than in the comparison group. 6 months after STEMI, there were no significant differences in Sm, E', E/E' values in the main and control groups, however, a lower LVEF and WMSI value was noted in comparison with the control group (p<0.05). Conclusion. Unidirectional positive dynamics of systolic-diastolic function parameters in hospital and post-hospital follow-up periods was observed in patients with STEMI, both those who had COVID-19 and without COVID-19 in the anamnesis. However, in patients who underwent COVID-19, there were more pronounced violations of LV systolic-diastolic function on 2-3 days and less pronounced, delayed positive dynamics of these parameters during the hospital and post-hospital treatment periods.