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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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INTRACARDIAC HEMODYNAMICS, CEREBRAL BLOOD FLOW AND MICROEMBOLIC SIGNAL BURDEN IN STABLE CORONARY ARTERY DISEASE

Vasyl Z Netiazhenko1, Serhii I Mostovyi2, Olga M Safonova3

  • 1BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; STATE INSTITUTION OF SCIENCE "RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE" STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|June 26, 2023
PubMed

Insights

Patients with stable coronary artery disease (SCAD) and COVID-19 showed impaired heart function and reduced cerebral blood flow (CBF). This group also experienced a higher burden of microembolic signals (MES) compared to those with SCAD or COVID-19 alone.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Stable coronary artery disease (SCAD) poses risks for cardiovascular events.
  • COVID-19 is known to affect multiple organ systems, including the cardiovascular system.
  • The combined impact of SCAD and COVID-19 on intracardiac hemodynamics and cerebral blood flow (CBF) requires further investigation.

Purpose of the Study:

  • To evaluate changes in intracardiac hemodynamics, cerebral blood flow (CBF), and microembolic signals (MES) burden.
  • To compare these parameters in patients with SCAD and concomitant COVID-19 against those with SCAD alone, COVID-19 alone, and healthy controls.

Main Methods:

  • A cross-sectional study involving 80 patients categorized into four groups: SCAD without COVID-19, SCAD with COVID-19, COVID-19 without SCAD, and healthy controls.
  • Transthoracic echocardiography was used to assess left ventricular (LV) function and dimensions.
  • Transcranial Doppler ultrasound was employed to measure CBF and quantify MES count.

Main Results:

  • Patients with SCAD and COVID-19 exhibited significant left ventricular (LV) dilation and reduced contractility compared to other groups.
  • A notable decrease in peak systolic velocities, indicating reduced CBF, was observed in all patient groups versus controls, most pronounced in the SCAD + COVID-19 group.
  • The highest microembolic signals (MES) burden was found in patients with COVID-19, with a slightly higher count in those also having SCAD.

Conclusions:

  • Concomitant COVID-19 in SCAD patients exacerbates LV dilation and systolic dysfunction.
  • The combination of SCAD and COVID-19 leads to a more pronounced drop in CBF and an increased MES burden.
  • Reduced LV contractility in this patient cohort is directly associated with a higher MES load.
Abstract

Keywords:
COVID-19SARS-CoV-2 infectioncerebrovascular circulationmyocardial ischemiamyocardium

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