PROSPECTIVE 12 MONTH FOLLOW-UP OF ELECTROCARDIOGRAPHIC CHANGES IN THE LEFT HEART OF COPD PATIENTS AFTER CORONAVIRUS INFECTION

Abstract

The impact of a new coronavirus infection (COVID-19) on the course of chronic obstructive pulmonary disease (COPD) and the development of complications in the long term remains an open question. This article presents the results of a study examining the dynamics of changes in the structural and functional parameters of the left heart in COPD patients who have had Covid-19 12 months after discharge from the hospital. Materials and methods. The prospective controlled trial included 73 patients with COPD who were divided into 2 groups: Group 1 (n=43) - patients with a history COVID-19; Group 2 (n=30) - patients without a history of COVID-19. The analysis included the results of a double echocardiographic examination of the left heart of the patients over a period of 12 months. Results and Discussion. It was found that in the acute phase of COVID-19, there were higher values LAV index, left ventricular (LV) end-diastolic volume (EDV) and LV end-diastolic size (EDS) (p>0.05) in-group 1. In12 months, both groups had mean values at the upper limit of normal. However, a significant increase in LV end-systolic size (p<0.05) and LV end-diastolic volume (EDV) (p<0.01) was observed in patients of group 1. LV EDS and LV EDV were also significantly higher in-group 1 (p<0.05). Initially, the normal type of LV diastolic function predominated in both groups. However, there were significantly more patients with LV diastolic dysfunction in-group 1 (χ2=4.59; p<0.05). At 12 months after COVID-19 in patients with COPD, there was an increase in E/a and the E/e' ratio (p<0.01). The relative risk of detecting LV diastolic dysfunction was 2.96 in-group 2. Thus, in patients with COPD against the background of COVID-19, early signs of LV dysfunction are detected, which worsen significantly after 12 months, and the risk of detecting LV diastolic dysfunction increases.