Title : Heart failure and the state of intracardiac hemodynamics in patients with atrial fibrillation depending on the past infection with COVID-19
Abstract:
Introduction: It is known that most patients with atrial fibrillation (AF) experience morphofunctional heart remodeling, and AF is one of the main causes of heart failure (HF). The aim of our study was to evaluate the course of HF, and to assess the state of intracardiac hemodynamics and cardiac contractility in patients with AF, depending on the past coronavirus infection (CI). Research material and methods: We examined 167 patients aged 62.5±0.09 years with AF, 14 of them (8.4%) also had atrial flutter. 118 people had a history of COVID-19 infection on average 6.2 + 0.5 months ago. They made up the 1st group of examined patients. The remaining 49 patients did not have a history of this infection. They constituted the 2nd group of the study group, which was the control group. The specific number of patients with paroxysmal, persistent and permanent forms of AF in the groups was comparable. Transthoracic echocardiography was performed according to the standard technique. Results of the study: As a result of the study, we found that the class of heart failure according to NYHA in patients of the examined groups did not differ - respectively 1.41 + 0.06 and 1.43 + 0.06, (ns) in patients of groups "1 " and 2". We also did not find any difference in hemodynamic parameters characterizing the systolic function of the left ventricle (LV). So, the values ??of the end-diastolic volume (117.0 + 7.6 mm and 116.0 + 7.2 mm), end-systolic volume (55.7 + 4.9 mm and 55.2 + 4.7 mm) and ejection fractions (55.0 + 2.1% and 54.4 + 2.0%) in the groups did not differ significantly. However, statistical significance was obtained in indicators characterizing LV diastolic function. So, significantly different flow rates in the 1st and 2nd groups of patients - E (60.8 + 1.63 sm/s and 94.6 + 2.97 sm/s, p<0.001), A (61.8 + 0.83 sm/s and 73.1 + 1.03 sm/s, p<0.001), their E/A ratios (0.98 + 0.02 and 1.39 + 0.03, p<0.001) and DE score (175.9 + 2.20 ms and 202.5 + 4.03 ms, p<0.001). A more significant violation of LV diastolic function after CI led to an increase in the diameter of the left atrium (LA) (4.99 + 0.14 cm in the 1st group compared with 4.40 + 0.004 cm in the 2nd group, p<0.001) and LA index (46.4 + 0.011 cm in the 1st group compared with 42.93 + 0.08 in the 2nd group, p<0.001). Conclusion: In patients with AF, after undergoing CI, the LV diastolic function begins to suffer first, which leads to an increase in the size of the LA. What will audience learn from presentation We found that the class of heart failure according to NYHA in patients with AF did not differ – respectively after a history of COVID-19 infection. We also did not find any difference in hemodynamic parameters characterizing the systolic function of the left ventricle (LV). But In patients with AF, after undergoing CI, the LV diastolic function begins to suffer first, which leads to an increase in the size of the left atrium.
