轻度至中度 COVID-19 近期康复患者的心肌工作指数

R. Dankowski, W. Sacharczuk, Julita Fedorowicz, Małgorzata Małek-Elikowska, S. Ożegowski, Artur Baszko
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摘要

背景/目标:在 COVID-19 的幸存者中,持续的心血管问题很常见,因此检测细微的心肌损伤至关重要。本研究评估了轻度至中度 COVID-19 患者的心肌工作(MW)指数。方法:共有 105 名刚刚康复的 COVID-19 患者(平均年龄 52 岁)接受了全面的实验室检测和高级超声心动图评估。他们感染 COVID-19 后的中位时间为 56 天(IQR:42-71)。根据高敏肌钙蛋白 I(hs-TnI)水平对组群进行了分层:检测不到与检测到。超声心动图分析利用压力-应变环来评估MW指数。结果42%的患者可检测到 hs-TnI 水平。整组患者的MW指数中位值略低于正常值:全局工作指数(GWI)-1834 mmHg%(IQR 1168-2054 mmHg%),全局建设性工作(GCW)-2130 mmHg%(IQR 2010-2398 mmHg%),全局浪费工作(GWW)-119 mmHg%(IQR 78-175 mmHg%),全局工作效率(GWE)-94%(IQR 92-96%)。检测到 hs-TnI 的患者 GWW 较高(168 对 97 mmHg%,p < 0.005),GWE 较低(93% 对 95%,p < 0.005)。在多元回归分析中,应变弥散(PSD)是 GWW 的唯一预测因子(β = 0.67,p < 0.001),而对于 GWE,PSD(β = -0.67,p < 0.001)和 LVEF(β = 0.16,p = 0.05)是显著的预测因子。结论在刚从轻度至中度 COVID-19 康复的患者中,hs-TnI 水平的升高与 GWE 的降低和 GWW 的升高有关。PSD 是预测心肌效率低下和工作浪费的重要指标。在这组患者中,心肌收缩时间和协调的紊乱可能是降低心脏工作效率的关键病理生理因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Myocardial Work Indices in Patients Recently Recovered from Mild-to-Moderate COVID-19
Background/Objectives: Persistent cardiovascular issues are common in COVID-19 survivors, making the detection of subtle myocardial injuries critical. This study evaluates myocardial work (MW) indices in patients recently recovering from mild-to-moderate COVID-19. Methods: A total of 105 recently recovered COVID-19 patients (who had a mean age of 52 years) underwent comprehensive laboratory testing and advanced echocardiographic assessments. The median time since their COVID-19 infections was 56 days (IQR: 42–71). The cohort was stratified based on high-sensitive troponin I (hs-TnI) levels: undetectable versus detectable. The echocardiographic analysis utilized pressure-strain loops to evaluate MW indices. Results: Detectable hs-TnI levels were observed in 42% of patients. The median values of MW indices for the entire group were slightly below normal values: global work index (GWI)—1834 mmHg% (IQR 1168–2054 mmHg%), global constructive work (GCW)—2130 mmHg% (IQR 2010–2398 mmHg%), global wasted work (GWW)—119 mmHg% (IQR 78–175 mmHg%), and global work efficiency (GWE)—94% (IQR 92–96%). Patients with detectable hs-TnI had higher GWW (168 vs. 97 mmHg%, p < 0.005) and lower GWE (93% vs. 95%, p < 0.005). In multiple regression analysis, strain dispersion (PSD) was the sole predictor for GWW (β = 0.67, p < 0.001), while for GWE, PSD (β = −0.67, p < 0.001) and LVEF (β = 0.16, p = 0.05) were significant predictors. Conclusions: Among patients recently recovering from mild-to-moderate COVID-19, elevated hs-TnI levels are linked with a reduction in GWE and an increase in GWW. PSD is an important predictor of myocardial inefficiency and wasted work. In this group, disruptions in the timing and coordination of cardiac muscle contractions may play a key pathophysiological role in reducing the efficiency of the heart’s performance.
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