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Ngenkathi i-COVID yesikhathi eside iphethe izimfihlakalo eziningi, abacwaningi bathole izinkomba zezimpawu ezijwayelekile zenhliziyo kulezi ziguli, okuphakamisa ukuthi ukuvuvukala okuqhubekayo kungumlamuleli.
Eqenjini leziguli ezingama-346 ezazinempilo ngaphambili ye-COVID-19, iningi lazo elahlala linezimpawu ngemuva kwezinyanga ezingaba ngu-4, ukuphakama kwezimpawu zesifo senhliziyo esakhiwe kanye nokulimala kwenhliziyo noma ukungasebenzi kwakungavamile.
Kodwa kunezibonakaliso eziningi zezinkinga zenhliziyo ezingaphansi, kubika u-Valentina O. Puntmann, MD, i-University Hospital Frankfurt, eJalimane, kanye nozakwabo e-Nature Medicine.
Uma kuqhathaniswa nezilawuli ezingatheleleki, iziguli ze-COVID zazinomfutho wegazi we-diastolic ophakeme kakhulu, zandise kakhulu izibazi ze-myocardial ezingezona ze-ischemic ngenxa yokuthuthukiswa sekwephuzile kwe-gadolinium, ukukhishwa kwe-pericardial okungahlobene ne-hemodynamically, kanye nokuphuma kwe-pericardial.<0,001). <0.001).
Ngaphezu kwalokho, ama-73% eziguli ze-COVID-19 ezinezimpawu zenhliziyo zazinamanani aphezulu emephu ye-MRI yenhliziyo (CMR) kunabantu abangenazimpawu, okukhombisa ukuvuvukala kwe-myocardial kanye nokunqwabelana okukhulu kokungafani kwe-pericardial.
"Esikubonayo akulungile," kusho uPuntmann etshela iMedPage Namuhla."Lezi yiziguli ezijwayelekile ngaphambilini."
Ngokuphambene nalokho okuvame ukucatshangwa ukuthi inkinga yenhliziyo nge-COVID-19, le miphumela inikeza ukuqonda kokuthi iziguli ezinezinkinga zenhliziyo ezivele zikhona kungenzeka ukuthi zilaliswe esibhedlela ngenxa yokugula okungathi sína nemiphumela.
Iqembu likaPuntman lifunde abantu abangenazo izinkinga zenhliziyo ukuzama ukuqonda umthelela we-COVID-19 uqobo, lisebenzisa izithombe ze-MRI zebanga locwaningo zeziguli ezibuthelwe emitholampilo yazo ngodokotela bemindeni, izikhungo zeziphathimandla zezempilo, izinto zokukhangisa ezisatshalaliswa iziguli ku-inthanethi.Amaqembu namawebhusayithi..
UPuntmann waphawula ukuthi yize leli kuyiqembu elikhethiwe leziguli okungenzeka lingameleli amacala athambile e-COVID-19, akuvamile ukuthi lezi ziguli zifune izimpendulo zezimpawu zazo.
Idatha yenhlolovo ye-Federal ikhombisa ukuthi amaphesenti ayi-19 abantu abadala baseMelika abangenwe yi-COVID babenezimpawu izinyanga ezi-3 noma ngaphezulu ngemuva kokutheleleka.Ocwaningweni lwamanje, ukuskena okulandelwayo okuyisilinganiso sezinyanga eziyi-11 ngemuva kokuxilongwa kwe-COVID-19 kubonise izimpawu zenhliziyo eziphikelelayo ku-57% wabahlanganyeli.Labo abasala benezimpawu babe ne-edema ye-myocardial ehlakazekile kakhulu kunalabo abalulama noma abangakaze babe nezimpawu (i-T2 37.9 yemvelo vs 37.4 kanye ne-37.5 ms, P = 0.04).
"Ukuzibandakanya kwenhliziyo kuyingxenye ebalulekile yokubonakaliswa kwesikhathi eside kwe-COVID - yingakho i-dyspnea, ukungabekezelelani umzamo, i-tachycardia," kusho uPontman engxoxweni.
Iqembu lakhe laphetha ngokuthi izimpawu zenhliziyo abazibonayo “zazihlotshaniswa nesilonda esivuvukalayo senhliziyo, esingase sichaze, okungenani ngokwengxenye, isisekelo se-pathophysiological sezimpawu zenhliziyo eziqhubekayo.Ngokuphawulekayo, ukulimala okukhulu kwe-myocardial noma isifo senhliziyo esihlelekile akusona isimo esivele sikhona futhi izimpawu azihambisani nencazelo yakudala ye-viral myocarditis.
Udokotela wenhliziyo kanye nesiguli sesikhathi eside se-COVID u-Alice A. Perlowski, MD, uveze imithelela ebalulekile yomtholampilo ngokubhala ku-tweet: “Lolu cwaningo lubonisa ukuthi ama-biomarker endabuko (kulokhu i-CRP, i-muscle calcin, NT-proBNP) angase angayisho yonke indaba. ”., #LongCovid, ngithemba ukuthi bonke odokotela ababona lezi ziguli zisebenza bazobhekana naleli phuzu elibucayi."
Kubantu abadala abangama-346 abane-COVID-19 (iminyaka yobudala engama-43.3 ubudala, abesifazane abangama-52%) abahlolwe esikhungweni esisodwa phakathi kuka-Ephreli 2020 no-Okthoba 2021, esikhathini esiyizinsuku eziyi-109 ngemuva kokuchayeka, uphawu oluvame kakhulu lwenhliziyo kwakuwukuzivocavoca ukuphefumula (62% ), ukushaya kwenhliziyo (28%), ubuhlungu besifuba obungavamile (27%), kanye ne-syncope (3%).
“Ukwazi ukuthi kuqhubekani ngokuhlolwa kwenhliziyo okujwayelekile kuyinselelo ngoba kunzima ukubona izimo ezingajwayelekile,” kusho uPuntmann.“Ingxenye yakho ihlobene ne-pathophysiology ngemuva kwayo… Noma ngabe umsebenzi wabo usengozini, akumangalisi kangako ngoba kunxephezela i-tachycardia kanye nenhliziyo ejabule kakhulu.Ngakho-ke asizange sibabone esigabeni esehlisiwe.”
Ithimba lihlela ukuqhubeka nokulandela lezi ziguli esikhathini eside ukuze liqonde ukuthi imithelela yomtholampilo engase ibe yini, lisaba ukuthi "kungase kumemezele umthwalo omkhulu wokumelwa yinhliziyo eminyakeni edlule," ngokusho kwewebhusayithi yalesi sikhungo.Ithimba liphinde laqala ucwaningo olulawulwa yi-placebo lwe-MYOFLAME-19 ukuhlola izidakamizwa ezilwa nokuvuvukala nezidakamizwa ezisebenza ohlelweni lwe-renin-angiotensin kulesi sibalo.
Ucwaningo lwabo lwaluhlanganisa kuphela iziguli ezingenaso isifo senhliziyo esaziwa ngaphambili, i-comorbidities, noma izivivinyo ezingasebenzi kahle zamaphaphu ekuqaleni futhi ezazingakaze zilaliswe esibhedlela ngenxa ye-COVID-19 eyingozi.
Iziguli ezengeziwe ezingama-95 emtholampilo ezazingenayo i-COVID-19 yangaphambili futhi ezazingenaso isifo senhliziyo esaziwayo noma izifo ezihambisana nazo zasetshenziswa njengezilawuli.Ngenkathi abacwaningi bevuma ukuthi kungase kube khona umehluko ongaziwa uma kuqhathaniswa neziguli ze-COVID, baphawule ukusatshalaliswa okufanayo kwezici eziyingozi ngeminyaka, ubulili, nesifo senhliziyo.
Phakathi kweziguli ezinezimpawu ze-COVID, iningi lalimnene noma lilinganisele (38% kanye nama-33%, ngokulandelana), futhi eziyisishiyagalolunye kuphela (3%) ezazinezimpawu ezinzima ezazikhawulela imisebenzi yansuku zonke.
Izinto ezibikezela ngokuzimela izimpawu zenhliziyo kusukela ekuhlolweni kwesisekelo ukuze kuskenwe kabusha okungenani ngemva kwezinyanga ezi-4 (izinsuku ezingama-329 ezimaphakathi ngemva kokuxilongwa) kwakuwubulili besifazane futhi kwasakaza ukubandakanyeka kwe-myocardial ekuqaleni.
"Ikakhulu, ngoba ucwaningo lwethu lugxile kubantu abanesifo sangaphambi kwe-COVID, aluzange lubike ukwanda kwezimpawu zenhliziyo ezingemuva kwe-COVID," kubhala iqembu likaPuntman."Kodwa-ke, ihlinzeka ngolwazi olubalulekile mayelana ne-spectrum yabo kanye nokuziphendukela kwemvelo okwalandela."
U-Puntmann kanye nozakwabo umbhali badalule izimali zokukhuluma ezivela ku-Bayer ne-Siemens, kanye nezibonelelo zemfundo ezivela ku-Bayer ne-NeoSoft.
Ingcaphuno yomthombo: I-Puntmann VO et al "Isifo senhliziyo sesikhathi eside kubantu abanesifo se-COVID-19 esiqala kancane", i-Nature Med 2022;I-DOI: 10.1038/s41591-022-02000-0.
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