在严重的COVID-19住院治疗后长期冠状动脉微血管和心脏功能障碍
Rebecka Steffen Johansson1,2, Daniel Loewenstein1,2, Klara Lodin1,3
1Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
JAMA network open
|June 9, 2025
概括
严重的COVID-19幸存者显示长期冠状动脉微血管功能障碍 (CMD) 和左心室功能减弱. 这些发现表明持续的心脏问题,突显了对COVID-19进一步研究的需要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗成像医学成像
背景情况:
- COVID-19与长期的心肺症状和冠状动脉微血管功能障碍 (CMD) 有关.
- 有限的长期数据存在关于严重COVID-19后的CMD.
- 了解这些长期影响对于患者管理至关重要.
研究的目的:
- 为了评估长期的左心室功能.
- 在严重的COVID-19后确定冠状动脉微血管功能障碍 (CMD) 的存在.
主要方法:
- 一项涉及重症COVID-19住院患者和健康志愿者的病例控制研究.
- 多参数输液心血管磁共振 (CMR) 成像在出院10个月后进行.
- CMR评估了原生T1,T2,细胞外体积,腺应激/休息输液,加多增强和电影成像.
主要成果:
- 分析了37名COVID-19幸存者和22名健康志愿者.
- 在COVID-19幸存者中,平均压力输液减少 (2.80对3.43毫升/分钟/g,P=.003).
- 在COVID-19幸存者中观察到全球纵向菌株 (-17%对 -19%,P=.003) 和全球环形菌株 (-16%对 -19%,P=.001) 的损伤.
结论:
- 患有严重COVID-19病史的患者长期表现出减少的压力输液,表明CMD.
- 在这些患者中,通过全球纵向和周围应变评估的左心室功能下降.
- 这些发现表明,由于严重的COVID-19导致CMD,需要对机制和治疗方法进行进一步调查.
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