The cardiac sequelae of coronavirus disease 2019 , a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.
Aim The objectives of this study were to determine the relationship between the systemic immune-inflammation index (SII) and new onset atrial fibrillation (NOAF) in patients with acute coronary syndrome (ACS), and to assess the use of this relation, if any, to predict NOAF in the context of ACSMaterial and Methods A total of 622 patients diagnosed with ACS and followed up between September 2019 and September 2021 were included in this study. 35 (5.6 %) of these patients, suffering from NOAF, were designated as the patient group, and the remaining 577 (94.4 %) patients were designated as the control group. SII was calculated with the formula [ (platelet count x neutrophil count) / lymphocyte count] in all patients.Results SII was significantly increased in the NOAF group [1641 (778-4506) vs. 660 (54-2835); p<0.001. The multivariable logistic regression analysis revealed that SII [OR: 1.002, 95 %CI: 1.001–1.002, p<0.001] is one of the independent predictors for NOAF, in addition to age (p=0.003) and left atrium size (p=0.005).Conclusion The SII index is an independent predictor of NOAF in ACS patients. This index can be used as an easily accessible value in the clinic. Assessment of risk factors for NOAF may permit early treatment and close follow-up of patients with poor prognosis who may develop AF.
It is well known that prevention is easier than cure. Constantly, scientific and technological developments continue to increase and it enables us new diagnostic and therapeutic methods. Prevention is also important for in the most common cause of persistent arrhythmiaatrial fibrillation (AF), to gain both medical and economic benefits. Studies have shown that atrial fibrillation is underdiagnosed and not adequately treated. Arrhythmia-atrial fibrillation is associated with cardiovascular and thromboembolic events, and higher mortality
Resumo Fundamento Menor redução da pressão arterial (PA) noturna, conhecida como hipertensão não-dipper, é um forte preditor de morbimortalidade cardiovascular. Objetivos Este estudo visou investigar a relação entre a hipertensão não-dipper e a gravidade e complexidade da doença arterial coronariana usando o escore SYNTAX em pacientes hospitalizados com síndrome coronariana aguda. Métodos Foram selecionados 306 pacientes consecutivos com síndrome coronariana aguda. Pacientes clinicamente estáveis internados na unidade de terapia intensiva intermediária pelo menos 24 horas após a angiografia e/ou revascularização bem sucedida. Após os critérios de exclusão, foram incluídos 141 pacientes (34 mulheres e 107 homens; idade média 61 ± 11 anos). A hipertensão não-dipper foi definida como uma queda de 0% a 10% na PA sistólica média durante a noite em comparação com o dia, medida em intervalos de 1 hora, usando o mesmo dispositivo automático de medição de PA em monitores de beira de leito (Vismo PVM-2701; Nihon Kohden Corp., Tóquio, Japão). O escore SYNTAX foi calculado com uma calculadora online. Os preditores independentes do escore SYNTAX foram avaliados por meio de análise de regressão logística multivariada. P < 0,05 foi considerado estatisticamente significativo. Resultados Os pacientes com hipertensão não-dipper apresentaram escore SYNTAX maior do que os pacientes com hipertensão dipper (11,12 ± 6,41 versus 6,74 ± 6,45, p < 0,0001). Em um modelo de regressão logística multivariável, o status de hipertensão não dipper (odds ratio: 5,159; intervalo de confiança de 95%: 2,246 a 11,852, p < 0,001), sexo (p = 0,012) e colesterol de lipoproteína de baixa densidade (p = 0,008) emergiram como preditores independentes de alto escore SYNTAX. Conclusões Os resultados do nosso estudo fornecem um possível mecanismo adicional ligando o perfil anormal da PA circadiana à gravidade e à complexidade da doença arterial coronariana em pacientes com síndrome coronariana aguda.
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