Intracardiac Hemodynamics, Cerebral Blood Flow and Microembolic Signal Burden in Stable Coronary Artery Disease Patients With Concomitant Covid-19

Abstract

The aim: To estimate the changes in intracardiac hemodynamics, cerebral blood flow (CBF), and microembolic signals` (MES) burden in stable coronary artery disease (SCAD) patients with concomitant COVID-19. Materials and methods: The cross-sectional study analyzed the data from 80 patients, being subdivided as follows: group 1 (G1) – SCAD without COVID-19 (n=30); group 2 (G2) – SCAD with concomitant COVID-19 (n=25); group 3 (G3) – COVID-19 without SCAD (n=25). The control group (CG) included 30 relatively healthy volunteers. CBF and total MES count were assessed by transcranial Doppler ultrasound. Results: Transthoracic echocardiography data from G2 revealed the most pronounced left ventricular (LV) dilation and its contractility decline (the rise of end-systolic volume (ESV) and ejection fraction decrease), as compared to G1 and G3. G1-G3 patients (vs. CG) presented with lower peak systolic velocities in all the studied intracranial arteries (middle and posterior cerebral arteries bilaterally, and basilar artery), along with the higher MES count. Such a drop in CBF was the most pronounced in G2. Both G2 and G3 demonstrated the highest amount of MES, with slightly higher count in G2. We built a linear neural network, discriminating the pattern of both higher LV ESV and MES count, being inherent to G2. Conclusions: G2 patients demonstrated the LV dilation and its systolic function impairment, and presented with CBF drop and MES burden increase, being more advanced in contrast to G1 and G3. LV contractility decrease was associated with the higher MES load in the case of SCAD and COVID-19 constellation.