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Cardiorespiratory function and contractile reserve with aortic regurgitation after COVID-19 recovery

Authors: Glushko L.A., Mironenko M.Yu., Mironenko V.A., Averina I.I., Avakova S.A., Lisina M.O., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular of Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-4-514-522

For citation: Glushko L.A., Mironenko M.Yu., Mironenko V.A., Averina I.I., Avakova S.A., Lisina M.O., Golukhova E.Z. Cardiorespiratory function and contractile reserve with aortic regurgitation after COVID-19 recovery. Creative Cardiology. 2024; 18(4): 514–522 (in Russ.). DOI: 10.24022/1997-3187-2024-18-4-514-522

Received / Accepted:  28.09.2024 / 12.11.2024

Keywords: COVID-19 cardiac function myocardial contractility aortic regurgitation cardiorespiratory function exercise tolerance pulmonary function

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Abstract

The aim of this study was to evaluate the impact of COVID-19 on the cardiorespiratory function and the contractile reserve of the heart in patients with aortic valve regurgitation during their recovery period.

Design of study – a single-center, retrospective study.

Material and methods. From January 2019 to August 2024, studies were conducted and data from 167 patients (89 men and 78 women) were analyzed within the group of pulmonary samples and gas exchange monitoring at the Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation. Patients were examined before the COVID-19 pandemic and in the recovery period. Patients underwent a comprehensive assessment of the cardiorespiratory system (computerized spirometry, assessment of lung diffusion capacity, cardiorespiratory stress testing, stress-echocardiography, including speckle-tracking stress-echocardiography) using Quark CPET (Cosmed, Italy), Ultima CardiO2 (Medical Graphics, USA), Epiq7 (Philips, Germany). The mean period after recovery from COVID-19 was 53.2 ± 3.4 days. The mean age of the patients was 45.4 ± 3.3 years.

Results. After the new coronavirus infection in patients with aortic regurgitation deterioration of cardiorespiratory function was noted. Statistically significant (p < 0.05) decrease of computerized spirometry data (forced expiratory volume in one second, forced vital capacity, maximum voluntary ventilation), decrease of lung diffusion capacity indices (lung diffusion capacity, corrected lung diffusion capacity, alveolar volume were registered. Statistically significant (p < 0.05) changes in cardiorespiratory function parameters were registered. Decrease in median peakVO2 (from 14.2 (12.6; 17.1) ml/kg/min to 11.1 (10.9;13.5) ml/kg/min reflected a decrease in the threshold of tolerance to physical load, increase in functional class of chronic heart failure (from 1.5 ± 0.2 to 2.9 ± 0.7). According to the data of stress-echocardiography there was an increase of aortic regurgitation degree from 1 to 2–3 degree, decrease of myocardial contractile reserve in the period of COVID-19 reconvalescence.

Conclusion. In order to detect severe aortic regurgitation to determine timely optimal tactics of treatment of COVID-19 deconditioned patients with aortic insufficiency, adequate prediction of risks of cardiorespiratory complications, a comprehensive assessment of the cardiorespiratory system is reasonable.

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About Authors

  • Liudmila A. Glushko, Cand. Med. Sci., Chief of Group, Functional Diagnostician, Cardiologist, Associate Professor of Department; ORCID
  • Marina Yu. Mironenko, Cand. Med. Sci., Ultrasound Diagnostician, Head of Department, Associate Professor of the Department; ORCID
  • Vladimir A. Mironenko, Dr. Med. Sci., Professor, Head of Department, Cardiovascular Surgeon; ORCID
  • Irina I. Averina, Dr. Med. Sci., Senior Researcher; ORCID
  • Susanna A. Avakova, Cand. Med. Sci., Head of Department;
  • Marina O. Lisina, Cand. Med. Sci., Researcher;
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director of the Center, Head of the Department; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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