The course of heart failure in patients after COVID-19 and the diagnostic role of furin

Abstract

Objective — to assess the impact of coronaviral diseases 2019 (COVID‑19) on the general state, laboratory and clinical indicators of patients with chronic heart failure (HF) with moderately reduced left ventricular ejection fraction (mrEF) and to investigate activity of furin. Materials and methods. A comprehensive examination involved 72 patients with HF with mrEF (main group) and 18 apparently healthy individuals (control group). The main group was divided into two subgroups: 36 subjects had COVID‑19 history, and 32 subjects without COVID‑19 history. The mean age of patients was (63.6±4.1) years. All study participants underwent anthropometric (height, weight, BMI), laboratory (clinical blood analysis, biochemical blood analysis with determination of AST, ALT, creatinine, glucose, lipid spectrum, potassium, sodium and magnesium, ELISA with determination of glycated hemoglobin, NT‑proBNP and furin), instrumental (EchoCS, ECG) examinations and surveys to assess the quality of life (EQ‑5D‑5L). Statistical processing of the obtained results was carried out using the SPSS v.19.0 statistical program package. Results. In the group of patients with a history of coronavirus infection compared to the patients without COVID‑19 history the following findings were established: significantly higher blood serum levels of NT‑proBNP (1002.79±215.94 pg/ml and 405.37±99.06 pg/ml, respectively, p‑value 0.01), uric acid (429.08±27.01 mmol/l vs. 354.44±28.75 mmol/l, p‑value 0.04) and a lower furin to NT‑proBNP ratio (0.87±0.26 and 1.38±1.16, p‑value 0.05). Results of EQ‑5D‑5L questionnaire demonstrated significant deterioration of quality of life indicators (64.21±3.04 points vs. 72.81±1.82 points by VAS, p‑value 0.02); higher indicators of left ventricular myocardial mass (LVMMi) (157.39±6.14 g/m2 and 138.68±6.02 g/m2, p‑value 0.03), dimensions of the left (43.74±0.95 mm and 41.12±0.85 mm, p‑value 0.04) and right atrium (40.76±1.23 mm and 37.75±0.85 mm, p‑value 0.04). Conclusions. Coronavirus infection in patients with heart failure with moderately reduced left ventricular ejection fraction resulted in the disorders of intracardiac hemodynamics and persistent negative structural changes of the heart. The ratio of furin to NT‑proBNP serum levels can be used to determine the impact of the HF syndrome itself on the patients’ subjective assessment of their quality of life.