Structural and functional changes of the heart in patients with coronary heart disease who have had coronavirus disease COVID-19

Abstract

The aim of the study: to investigate the effect of the previous COVID-19 coronavirus disease on the features of cardiac remodeling in patients with coronary heart disease (CHD). Materials and methods. 71 patients with CHD were involved in the study: stable angina pectoris II–III FC (age 69.0 (64.0; 76.0) years): 1 group (main) – 31 patients with CHD in long COVID-19 period; group 2 (comparison) – 40 patients with CHD without a history of COVID-19. Features of cardiac remodeling and energy work of the left ventricular (LV) myocardium were assessed using the echocardiography method. Results. CHD patients with a history of COVID-19 had greater changes in linear and volumetric parameters of the heart, an increase in the degree of hypertrophy of the LV myocardium, frequency of registration of LV diastolic dysfunction against the background of an increase in the mean pressure in the pulmonary artery, end-systolic pressure, decrease in global LV contractile function (LVF) compared to patients without COVID-19 history (p < 0.05). In CHD patients who suffered from COVID-19, there was an increase in the estimated energy expenditure of the LV myocardium: shock work by 14.77 % (U = 461.5; p < 0.05), potential energy by 34.68 % (U = 316.5; p < 0.05) and the pressure-volume zone by 17.78 % (U = 373.0; p < 0.05), which indicates a decrease in the speed of myocardial recovery in long COVID period. It was established that the presence of COVID-19 in the history of patients with CHD is associated with an increased risk of LV dilatation by 5.6 times (95 % CI 1.71–18.29; p < 0.05), LV myocardial hypertrophy by 3.05 times (95 % CI 1.79–5.91; p < 0.05), LV diastolic dysfunction by 1.44 times (95 % CI 0.91–2.29; p < 0.05), an increase in energy expenditure during heart work by 1.66 times (95 % CI 0.68–4.02; p < 0.05). Conclusions. Patients with coronary heart disease have more significant structural and functional changes and energy expenditure during the work of the heart, which proves the negative impact of SARS-CoV-2 on the state of cardiac remodeling in patients with CHD in long COVID-19 period.