Department of cardiology, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Department of Chest, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Int J Cardiovasc Imaging. 2023 Jun;39(6):1115-1122. doi: 10.1007/s10554-023-02819-9. Epub 2023 Mar 6.
Post-acute sequelae of SARS-CoV-2 (PASC) have emerged as a major health issue in patients who have previously been infected with Covid-19 virus.
we aimed at the assessment of functional outcomes in post Covid-19 patients with persistent dyspnea using a multidisciplinary approach including clinical assessment, laboratory investigations, exercise ECG, and different echo-Doppler modalities, including left atrial functions.
The current observational randomized controlled study conducted on 60- patients one month after recovery from Covid-19 infection presented with persistent dyspnea compared to 30 healthy volunteers. All participants were subjected to evaluation of dyspnea by different scores, laboratory investigations, stress ECG, and echo-Doppler examination to measure LV dimensions, volumes, systolic and diastolic functions by M-mode, 2D, and tissue Doppler imaging in addition to 2-D speckle tacking LA strain.
Post Covid-19 patients had persistent elevation of inflammatory markers, low functional capacity (evidenced by a higher NYHA class, m MRC score, PCFS scale) and decreased METs by stress ECG compared to control group. Post Covid-19 patients showed LV diastolic dysfunction and impairment of 2D-STE LA functions compared to control group. We found negative correlations between LA strain with NYHA class, mMRC scale, LAVI, ESR and CRP; meanwhile, there were significant positive correlations between LA strain with exercise duration and METs.
post Covid patients presented with persistent dyspnea demonstrated low functional capacity evidenced by different scores and stress ECG. Moreover, patients with post Covid syndrome showed elevated inflammatory biomarkers, LV diastolic dysfunction in addition to impaired LA strain functions. Impairment of LA strain was closely correlated to different functional scores, inflammatory biomarkers, exercise duration, and METs suggesting that these could to be the possible etiologies for the persistence of post Covid symptoms.
SARS-CoV-2（新冠病毒）的急性后期后遗症已成为曾经感染过新冠病毒的患者的一个主要健康问题。
我们旨在通过多学科方法评估新冠后持续性呼吸困难患者的功能结局，该方法包括临床评估、实验室检查、运动心电图和不同的超声心动图模式，包括左心房功能。
本观察性随机对照研究共纳入 60 名患者，这些患者在新冠病毒感染后一个月出现持续性呼吸困难，与 30 名健康志愿者进行比较。所有参与者均接受不同评分的呼吸困难评估、实验室检查、应激心电图和超声心动图检查，以通过 M 模式、二维、组织多普勒成像以及二维斑点追踪测量左心室的尺寸、容积、收缩和舒张功能，并测量左心房应变。
与对照组相比，新冠后患者的炎症标志物持续升高，运动能力较低（表现为 NYHA 心功能分级更高、mMRC 评分更高、PCFS 量表评分更高），应激心电图的 MET 值更低。与对照组相比，新冠后患者的左心室舒张功能障碍和二维斑点追踪左心房功能受损。我们发现左心房应变与 NYHA 心功能分级、mMRC 评分、左心房容积指数、红细胞沉降率和 C 反应蛋白呈负相关，而与运动时间和 MET 值呈正相关。
表现出持续性呼吸困难的新冠后患者运动能力较低，这一情况通过不同评分和应激心电图表现出来。此外，患有新冠后综合征的患者表现出炎症标志物升高、左心室舒张功能障碍以及左心房应变功能受损。左心房应变功能受损与不同的功能评分、炎症标志物、运动时间和 MET 值密切相关，提示这些可能是新冠后症状持续存在的潜在病因。
