长期COVID患者的心脏功能和功能能力:与倾向匹配社区控制的比较
Thomas H Marwick1, Noah Wexler2, Joel Smith3
1Imaging Research Lab, Baker Heart and Diabetes Institute, Hobart, Tasmania, Australia; Baker Department of Cardiometabolic Health, University of Melbourne, Melbourne, Victoria, Australia; Department of Cardiology, Western Health, Melbourne, Victoria, Australia; Department of Cardiology, Royal Hobart Hospital, Hobart, Tasmania, Australia; Cardiovascular Health Flagship, Menzies Institute for Medical Research, Hobart, Tasmania, Australia.
概括
长期COVID与亚临床心脏功能障碍,特别是左心室尺寸变化和全球纵向应变 (GLS) 损伤有关. 这种心脏功能障碍独立于传统的风险因素,并导致患者的功能限制.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 心脏功能障碍是急性COVID-19的一个已知的并发症.
- 心脏功能障碍在长期COVID (COVID-19的后急性后果) 中的作用尚不清楚.
- 以前对长期COVID中心血管参与的研究往往缺乏对照组.
研究的目的:
- 为了比较长期COVID患者的心脏功能障碍的患病率与未感染的对照人群.
- 研究长期COVID中心脏功能障碍和功能能力之间的关联.
主要方法:
- 心声图被用来评估心脏结构和功能,包括全球纵向应变 (GLS).
- 190名长期COVID患者与979名历史对照人群进行了比较,使用倾向性得分匹配.
- 用主观 (杜克活动状态指数) 和客观 (6分钟步行测试) 的措施来评估功能能力.
主要成果:
- 长期COVID患者表现出改变的左心室尺寸和几何形状.
- 在长期COVID组中发现了亚临床缩功能障碍,这表明GLS显著降低,GLS异常的患病率更高.
- 长期COVID独立地与主观和客观功能障碍相关,与传统风险因素相比,相关性更强.
结论:
- 全球纵向菌株受损和左心室尺寸改变是长期COVID的关键心声图发现.
- 这些心脏变化在长期COVID患者中过度表现,并且独立于其他风险因素.
- 虽然受损的GLS与功能障碍有很弱的关联,但长期COVID本身是功能缺陷的强有力的独立预测因素.
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