PECULIARITIES OF CHANGES IN CARDIOHEMODYNAMICS AND ELECTRICAL ACTIVITY OF THE HEART IN ACUTE MYOCARDITIS ASSOCIATED WITH CORONAVIRUS INFECTION (COVID-19)

Chekalina N. I., Kazakov Yu. M., Borysova Z. O., Ivashuta I. M., Kirusha I. S.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Abstract. Introduction. Coronavirus infection (COVID-19) causes the frequent development of cardiovascular disorders. Today, almost a third of people who have suffered from COVID-19 present with myocarditis, and autopsy demonstrates a rate of myocardial infarction of 59%. The aim of the research is to study the electrocardiographic and echocardiographic parameters in patients with acute myocarditis (AM) associated with COVID-19, as well as their relationship. Materials and methods: We conducted a retrospective clinical study. The object of the study embraced 20 patients with AM against the background of COVID-19 of both sexes aged 55.6+2.8 years. The control group consisted of 15 apparently healthy individuals. The subject of the study focused on the results of daily Holter monitoring of the electrocardiogram (ECG) and echocardiographic examination protocols. Statistical data processing included the calculation of arithmetic mean and mean error, the relationships between indicators were determined by Pearson correlation analysis. Results. In patients with AM, we found an increase in the end-diastolic and systolic sizes of the left ventricle, the diameter of the right ventricle, both atria, and an impaired diastolic function of the left ventricle by the type of relaxation disorder. Ventricular and supraventricular extrasystoles were determined, episodes of ST-segment depression were detected. Pulmonary hypertension was observed in 13 patients, and pericardial effusion – in 10 subjects. Total pericardial effusion thickness, inferior vena cava diameter, end-diastolic size, and left ventricular volume were positively correlated with pulmonary artery pressure. The rates of early diastolic filling of the left and right ventricles had a direct correlation, which indicates identical changes in the relaxation of the myocardium of both chambers in the inflammatory process in AM. A close direct correlation was determined between the diameters of the atria, between the rates of early diastolic filling of the left and right ventricles. The daily number of ventricular arrhythmias correlated with the diameter of the right ventricle, which may be due to its overload in the conditions of pulmonary hypertension. Conclusions. COVID-19-associated AM is characterized by electrical instability and subendocardial myocardial ischemia, left and right ventricular volume overload, frequent development of pulmonary hypertension, especially in the presence of pericardial effusion.

acute myocarditis, COVID-19, daily Holter ECG monitoring, echocardiography

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«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 158-162 pages, index UDK 616.127-002:616.98.21/.958.7

10.29254/2077-4214-2021-3-161-158-162