基于斑点跟踪超声心动图的左心室节段性应变与COVID-19肺炎患者免疫炎症适应症的比较

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
N. Shirokov, E. Yaroslavskaya, D. Krinochkin, N. A. Osokina, N. Musikhina, T. I. Petelina
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Methods — Our study encompassed 216 patients (51.1% men, mean age of 50.1±11.1 years) distributed among two groups: Group I (n=108) included study subjects with segmental LS (≥3 LV segments) revealed by the STE; Group II (n=108) comprised patients without visually detectable LV lesions. All patients were examined three months after COVID-19 pneumonia. Results — Groups did not differ statistically significantly in terms of LV ejection fraction (68.7±4.3% in Group I vs. 68.6±4.3% in Group II; p=0.916). Global LS was significantly lower in the Group I than in the Group II at the time of the control follow-up visit three months later (-18.2 [-16.7; -19.4] % vs. -20.6 [-19.5; -22.1] %, respectively; p<0.001). 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引用次数: 0

摘要

背景-细胞因子激活和免疫炎症在心肌细胞亚临床损伤和充血性心力衰竭(CHF)发展中的意义在已发表的研究中经常讨论,以及斑点追踪超声心动图(STE)确定的新冠肺炎幸存者是否存在心脏病变。目的-根据STE确定的左心室节段纵向应变(LS),研究超声心动图参数与新冠肺炎肺炎康复患者免疫炎症指征的关系。方法——我们的研究包括216名患者(51.1%男性,平均年龄50.1±11.1岁),分布在两组:第一组(n=108)包括STE显示的节段LS(≥3个左心室节段)的研究受试者;第II组(n=108)包括没有可见左心室病变的患者。所有患者均在新冠肺炎肺炎后三个月接受检查。结果——各组左心室射血分数无统计学差异(第一组为68.7±4.3%,第二组为68.6±4.3%;p=0.916)。三个月后进行对照随访时,第一组的整体LS显著低于第二组(分别为-18.2[-16.7;-19.4]%和-20.6[-19.5;-22.1]%;p<0.001)在各组免疫炎症指征中,我们发现第一组与第二组在白细胞介素6(3.1[2.4;3.9]pg/mL vs.2.5[3.8;4.7]pg/mL;p=0.009)、C反应蛋白(4.7[2.9;8.3]mg/L vs.3.0[1.5;5.3]mg/L;p<0.001)和肿瘤坏死因子α(6.0[4.8;4.1]pg/mL vs.5.0[4.0;6.4]pg/mL;p=0.001)的浓度方面具有统计学意义的更高值,我们检测到LS的弥漫性病变(≥4个左心室水平相同的节段;38.0%的患者)和LS的区域性病变(至少3个节段对应于前冠状动脉、回旋支或右冠状动脉的血供池;62.0%患者)。根据逻辑回归,基础左心室水平的LS(OR 3.028;95%CI 1.909-4.802;р<0.001)与心尖左心室水平LS(OR 1.287;95%CI 1.099-1.507;р=0.002)和组织多普勒成像评估的左心室侧壁环速度相结合,峰值e’(OR 0.774;95%CI 0.657-0.911;р=0.002)与弥漫性和区域性LS病变具有独立关系。结论-根据STE数据,我们已经确定了新冠肺炎肺炎患者三个月后弥漫性和区域性左心室病变与左心室收缩和舒张功能障碍特征以及免疫炎症标志物的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Left Ventricular Segmental Strain Based On Speckle Tracking Echocardiography Versus Indications Of Immune Inflammation In Patients After COVID-19 Pneumonia
Background — The significance of cytokine activation and immune inflammation in subclinical damage to cardiomyocytes and resulting development of the congestive heart failure (CHF) is frequently discussed in published studies, as well as whether there are cardiac lesions in COVID-19 survivors identified by the speckle tracking echocardiography (STE). Objective — To examine the association of echocardiographic parameters with indications of immune inflammation in patients recovered from COVID-19 pneumonia depending on segmental longitudinal strain (LS) of the left ventricle (LV) identified by STE. Methods — Our study encompassed 216 patients (51.1% men, mean age of 50.1±11.1 years) distributed among two groups: Group I (n=108) included study subjects with segmental LS (≥3 LV segments) revealed by the STE; Group II (n=108) comprised patients without visually detectable LV lesions. All patients were examined three months after COVID-19 pneumonia. Results — Groups did not differ statistically significantly in terms of LV ejection fraction (68.7±4.3% in Group I vs. 68.6±4.3% in Group II; p=0.916). Global LS was significantly lower in the Group I than in the Group II at the time of the control follow-up visit three months later (-18.2 [-16.7; -19.4] % vs. -20.6 [-19.5; -22.1] %, respectively; p<0.001). When analyzing laboratory indications of immune inflammation in groups, we revealed statistically significantly higher values in Group I vs. Group II in the concentrations of interleukin 6 (3.1 [2.4;3.9] pg/mL vs. 2.5 [3.8;4.7] pg/mL; p=0.009), C-reactive protein (4.7 [2.9;8.3] mg/L vs. 3.0 [1.5; 5.3] mg/L; p<0.001), and tumor necrosis factor α (6.0 [4.8;4.1] pg/ml vs. 5.0 [4.0;6.4] pg/ml; p=0.001). In Group I, we detected diffuse lesion of LS (≥4 segments of the same LV level; 38.0% of patients) and regional lesion of LS (≥3 segments corresponding to the blood supply pools of the anterior, circumflex, or right coronary arteries; 62.0% of patients). According to logistic regression, the LS of the basal LV level (OR 3.028; 95% CI 1.909-4.802; р<0.001) in combination with LS of the apical LV level (OR 1.287; 95% CI 1.099-1.507; р=0.002) and LV lateral wall annular velocity assessed by tissue Doppler imaging, peak e’ (OR 0.774; 95% CI 0.657-0.911; р=0.002) had an independent relationship with each of diffuse and regional LS lesions. Conclusion — Based on STE data, we have identified a relationship of diffuse and regional LV lesions with features of systolic and diastolic LV dysfunction and markers of immune inflammation in patients three months after COVID-19 pneumonia.
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来源期刊
Russian Open Medical Journal
Russian Open Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
39
期刊介绍: Russian Open Medical Journal (RusOMJ) (ISSN 2304-3415) is an international peer reviewed open access e-journal. The website is updated quarterly with the RusOMJ’s latest original research, clinical studies, case reports, reviews, news, and comment articles. This Journal devoted to all field of medicine. All the RusOMJ’s articles are published in full on www.romj.org with open access and no limits on word counts. Our mission is to lead the debate on health and to engage, inform, and stimulate doctors, researchers, and other health professionals in ways that will improve outcomes for patients. The RusOMJ team is based mainly in Saratov (Russia), although we also have editors elsewhere in Russian and in other countries.
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