Functional Status Of Cardiovascular System Research Articles

Long-term impact of COVID-19 on cardiovascular health of healthcare workers of a tertiary care hospital of Bangladesh

Background: The coronavirus disease (COVID-19) is a multisystem disease that sometimes affects the cardiovascular system (CVS) during acute illness and follows a protracted course in a proportion of patients causing ‘post-COVID syndrome’. Exercise tolerance test (ETT) can assess functional capacity and imaging modalities like echocardiography and cardiac magnetic resonance (CMR) can assess structural and functional status of cardiovascular system (CVS) efficiently. However, the pattern of cardiovascular involvement and its effect on functional capacity in COVID-19 survivors long after the index illness are inadequately known. This study was carried out to detect the functional status and imaging findings in COVID-19 recovered healthcare workers.
 Methods: This cohort study was carried out in the Department of Cardiology of the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from July 2021 to December 2021. Thirty male healthcare workers, previously not known to have any cardiac disease, who suffered from reverse transcriptase polymerase chain reaction (RT-PCR)-confirmed COVID-19 of mild severity at least 3 months back were included. Besides clinical evaluation, ETT, echocardiography and CMR were done.
 Results: The mean age was 37.2±4.7 years. The mean time interval from RT-PCR positivity was 317.4±85.7 days. The functional capacity was good in the study subjects; the achieved metabolic equivalents (METs) were 13.0±1.5. The mean left ventricular ejection fraction (LVEF) was 66.9% ± 6.2%; all were within the normal range. The mean LV global longitudinal strain (LVGLS) was -19.2% ± -1.9%; 6 patients had LVGLS <-18%. One patient had mildly reduced tricuspid annular plane systolic excursion (TAPSE) of 16 mm but 3 patients had reduced lateral tricuspid annulus peak systolic velocity (RVS’). CMR revealed subtle abnormalities in 14 (46.7%) patients. Eight patients (26.67%) had increased T2 signal indicating myocardial oedema, 2 (6.7%) had subepicardial late gadolinium enhancement (LGE).
 Conclusion: In healthcare workers who recovered from mild COVID-19, despite preserved functional capacity, subclinical cardiac abnormalities detected by echocardiography and CMR may be present. Long-term follow-up is warranted to define the clinical significance of these findings.
 BIRDEM Med J 2023; 13(1): 3-11

Effect of xenon-oxygen inhalations on functional status of cardiovascular system in oncological patients suffering chronic pain syndrome

Purpose of the study. Assessment of xenon-oxygen inhalations effect on functional status of cardiovascular system in oncological patients with chronic pain syndrome.Materials and methods. Randomized double-blinded placebo-controlled clinical trial with assessment of xenon-oxygen inhalations effect on electrocardiogaram, blood pressure and heart rate was performed in oncological patients with chronic pain syndrome received analgetic drug therapy. 48 of them were in the main group and received xenon-oxygen-air mixture containing 50 % xenon and 50 % oxygen twice a day during 7 visits, and other 47 were in control group and received oxygen-air mixture containing 50 % oxygen. Level of pain severity according to numerical rating scale and satisfaction of patients on the base of questionary were also assessed.Results. No significant negative effects of xenon on electrocardiogaram were revealed. In the main group alike the control group the QT intervals did not increase. There were multidirectional changes of T-wave without clinical symptoms in main and control groups. Xenon had no influence on heart rate but lead to statistically significant systolic and diastolic blood pressure decrease. Pain severity was significantly alleviated in the main group from 50 [40; 60] to 40 [25; 50]%; p < 0,05. Satisfaction of the patients in xenon group was 71 % vs 11 % in control group; p = 0,0001.Conclusion. Xenon-oxygen inhalations had no negative side effects on electrocardiogram, blood pressure and heart rate in oncological patients with chronic pain syndrome. Xenon inclusion in complex therapy increased effectiveness of pain treatment and satisfaction of the patients.

Effect of rosuvastatin therapy in patients with atherosklerosis

Objectives: We investigated the anti-atherosclerotic effects of rosuvastatin (RSF). For this purpose we studied indicators of lipid metabolism, endothelial functions, functional status of cardiovascular system.

Heart rate and systolic blood pressure response during the early exercise test and cardiovascular mortality after myocardial infarction

Exercise cardiography still remains the cornerstone of noninvasive evaluation of functional status of cardiovascular system and is almost uniformly performed after myocardial infarction. The patients after myocardial infarction can be divided into relative high- and low-risk groups for subsequent cardiac events if all information available on the exercise test is used. The aim of this study was to evaluate the prognostic significance of the shape of heart rate and systolic blood pressure curves (their dynamic characteristics) during the early exercise testing and after it and to design the prognostic system capable to recognize patients with a high risk of coronary death during 2 years after myocardial infarction. The submaximal exercise testing within 3 weeks of acute myocardial infarction was performed on 894 patients. Cases of noncardiac deaths or patients subjected to coronary bypass surgery were excluded from the further analysis. At the end of 2 years after myocardial infarction, there were 426 survivors and 42 cases of cardiac death. At 2-year follow-up after infarction in the nonsurvivor group, there were only 42.2% of patients with exercise-induced ST segment depression. This shows that prognostic importance of ST depression is insufficient and demands research of more consistent signs. The cardiovascular response to exercise was interpreted as transiting process of self-regulation of cardiovascular system, and the new predictive signs were found based on the curves of heart rate and systolic blood pressure during the exercise and after it. The prognostic value of these signs was established. The combined use of both the new predictive signs and usual data of early exercise test shows the high predictive possibility of test - the early cardiac death was predicted in 80% of cases. The combined use of both, the widely accepted data of early exercise test after myocardial infarction and dynamic characteristics of heart rate and systolic blood pressure, increased the predictive power of the test.

Calcium-regulating peptide hormones and blood electrolytic balance in chronic heart failure

Calcium-regulating system is important for the functional activity of myocardium. However, little is known about the role of this system in the pathogenesis of cardiovascular diseases. Blood samples from the patients with chronic heart failure (CHF) caused by ischaemic disease (coronary artery disease) (NYHA class I–IV) were used to analyze the levels of calcium, inorganic phosphate, sodium, potassium, parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP). The heart beat rate and arterial blood pressure were chosen as additional tests for the functional status of cardiovascular system. The alteration of electrolytes homeostasis was found dependent on the severity of the pathology being maximally expressed in the NYHA class IV patients. Similar tendency was demonstrated for circulating PTH and PTHrP with the highest blood concentrations observed in patients of the NYHA class III and IV. The extent of these changes was found more pronounced in the female patients. It is suggested that the calcium-regulating hormonal system is involved in the pathogenesis of the ischaemic heart disease; however the sharp increase of PTH and PTHrP at the severe stages of pathology may play a compensatory role in maintaining the heart function.

Simulation study of the cardiovascular functional status in hypertensive situation

An extended cardiovascular model was established based on our previous work to study the consequences of physiological or pathological changes to the homeostatic functions of the cardiovascular system. To study hemodynamic changes in hypertensive situations, the impacts of cardiovascular parameter variations (peripheral vascular resistance, arterial vessel wall stiffness and baroreflex gain) upon hemodynamics and the short-term regulation of the cardiovascular system were investigated. For the purpose of analyzing baroregulation function, the short-term regulation of arterial pressure in response to moderate dynamic exercise for normotensive and hypertensive cases was studied through computer simulation and clinical experiments. The simulation results agree well with clinical data. The results of this work suggest that the model presented in this paper provides a useful tool to investigate the functional status of cardiovascular system in normal or pathological conditions.