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从重症新冠病毒疾病中康复的个体易患心房颤动。

Individuals Recovered from Severe COVID-19 are Predispose to Develop Atrial Fibrillation.

作者信息

Yılmaz Mücahid, Mirzaoğlu Çetin

机构信息

University of Health Sciences, Elazığ Fethi Sekin City Hospital, Department of Cardiology, Elazığ, Turkey.

出版信息

Int J Gen Med. 2025 Aug 12;18:4379-4390. doi: 10.2147/IJGM.S527058. eCollection 2025.

Abstract

AIM

One of the primary contributors of the development of atrial fibrillation (AF) is autonomic dysfunction. It is suggested that heart rate turbulence (HRT) be utilized to assess autonomic nervous system (ANS) function. In this research, we analyzed the impact of COVID-19 on atrial fibrillation predisposition in the post-recovery period by analyzing atrial HRT measurements of patients who described palpitations in the post-COVID-19 period.

METHODS

This study included 407 healthy participants without a positive COVID-19 record and 328 patients having a verified positive COVID-19 record (recovered COVID-19). All subjects were categorized into four groups (controls, recovered mild COVID-19, recovered moderate COVID-19 and recovered severe COVID-19) based on the severity value of their chest CT scan. The atrial HRT analyses were taken from a 24-hour electrocardiography- Holter recording.

RESULTS

This study revealed that atrial HRT Onset values were significantly higher in the recovered severe COVID-19 group than the other groups. A positive association was found between the atrial HRT onset value and the chest CT severity value. However, no relationship was found between the atrial HRT onset value and the number of positive PCR test for COVID-19 or the amount of time that had passed since COVID-19. Regression analysis showed that the chest CT severity score, HT, smoking, and recovery from severe COVID-19, were independent predictors of atrial HRT Onset values and abnormal atrial HRT Onset existence.

CONCLUSION

Blunted atrial HRT, considered a significant predisposition to the development of atrial fibrillation, is more likely to occur in people who recovered from serious COVID-19 than in individuals who have never had severe COVID-19. These individuals should be carefully evaluated for atrial HRT.

摘要

目的

自主神经功能障碍是心房颤动(AF)发展的主要促成因素之一。有人建议利用心率震荡(HRT)来评估自主神经系统(ANS)功能。在本研究中,我们通过分析新冠疫情后出现心悸症状患者的心房HRT测量值,分析了新冠病毒感染疾病(COVID-19)对康复期心房颤动易感性的影响。

方法

本研究纳入了407名无COVID-19阳性记录的健康参与者和328名经证实有COVID-19阳性记录(COVID-19康复者)的患者。根据胸部CT扫描的严重程度值,将所有受试者分为四组(对照组、轻度COVID-19康复组、中度COVID-19康复组和重度COVID-19康复组)。心房HRT分析取自24小时心电图动态监测记录。

结果

本研究显示,重度COVID-19康复组的心房HRT起始值显著高于其他组。心房HRT起始值与胸部CT严重程度值之间存在正相关。然而,未发现心房HRT起始值与COVID-19核酸检测阳性次数或自感染COVID-19以来过去的时间之间存在关联。回归分析表明,胸部CT严重程度评分、高血压、吸烟以及从重度COVID-19中康复,是心房HRT起始值和异常心房HRT起始存在的独立预测因素。

结论

心房HRT减弱被认为是心房颤动发生的重要易患因素,在从严重COVID-19中康复的人群中比在从未患过严重COVID-19的个体中更易发生。应对这些个体进行心房HRT的仔细评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127b/12357568/520e656dbe49/IJGM-18-4379-g0001.jpg

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