Aranyó Júlia, Bazan Victor, Lladós Gemma, Dominguez Maria Jesús, Bisbal Felipe, Massanella Marta, Sarrias Axel, Adeliño Raquel, Riverola Ariadna, Paredes Roger, Clotet Bonaventura, Bayés-Genís Antoni, Mateu Lourdes, Villuendas Roger
Cardiology Department, Heart institute, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain.
Department of Infectious Disease, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.
Sci Rep. 2022 Jan 7;12(1):298. doi: 10.1038/s41598-021-03831-6.
Inappropriate sinus tachycardia (IST) is a common observation in patients with post-COVID-19 syndrome (PCS) but has not yet been fully described to date. To investigate the prevalence and the mechanisms underlying IST in a prospective population of PCS patients. Consecutive patients admitted to the PCS Unit between June and December 2020 with a resting sinus rhythm rate ≥ 100 bpm were prospectively enrolled in this study and further examined by an orthostatic test, 2D echocardiography, 24-h ECG monitoring (heart rate variability was a surrogate for cardiac autonomic activity), quality-of-life and exercise capacity testing, and blood sampling. To assess cardiac autonomic function, a 2:1:1 comparative sub-analysis was conducted against both fully recovered patients with previous SARS-CoV-2 infection and individuals without prior SARS-CoV-2 infection. Among 200 PCS patients, 40 (20%) fulfilled the diagnostic criteria for IST (average age of 40.1 ± 10 years, 85% women, 83% mild COVID-19). No underlying structural heart disease, pro-inflammatory state, myocyte injury, or hypoxia were identified. IST was accompanied by a decrease in most heart rate variability parameters, especially those related to cardiovagal tone: pNN50 (cases 3.2 ± 3 vs. recovered 10.5 ± 8 vs. non-infected 17.3 ± 10; p < 0.001) and HF band (246 ± 179 vs. 463 ± 295 vs. 1048 ± 570, respectively; p < 0.001). IST is prevalent condition among PCS patients. Cardiac autonomic nervous system imbalance with decreased parasympathetic activity may explain this phenomenon.
不适当窦性心动过速（IST）在新冠后综合征（PCS）患者中很常见，但迄今为止尚未得到充分描述。为了调查PCS患者前瞻性队列中IST的患病率及其潜在机制。2020年6月至12月期间入住PCS病房、静息窦性心律率≥100次/分钟的连续患者被前瞻性纳入本研究，并通过直立倾斜试验、二维超声心动图、24小时心电图监测（心率变异性作为心脏自主神经活动的替代指标）、生活质量和运动能力测试以及血液采样进行进一步检查。为了评估心脏自主神经功能，对既往感染过SARS-CoV-2的完全康复患者和未感染过SARS-CoV-2的个体进行了2:1:1的比较亚分析。在200例PCS患者中,40例（20%）符合IST诊断标准（平均年龄40.1±10岁，85%为女性，83%为轻度新冠感染）。未发现潜在的结构性心脏病、促炎状态、心肌细胞损伤或缺氧。IST伴有大多数心率变异性参数降低，尤其是与心迷走神经张力相关的参数：pNN50（病例组3.2±3，康复组10.5±8，未感染组17.3±10；p<0.001）和高频频段（分别为246±179、463±295和1048±570；p<0.001）。IST在PCS患者中很普遍。心脏自主神经系统失衡伴副交感神经活动减少可能解释了这一现象。
