“This could lead to new therapies to prevent strokes and heart attacks in certain COVID-19 patients who are at the highest risk,” says Allison Hays, M.D., medical director of echocardiography packages at The Johns Hopkins Hospital and senior writer of the printed paper.
Patients who’re hospitalized with COVID-19 have greater than double the speed of arrhythmias, together with atrial fibrillation and atrial flutter, an analogous speedy rhythm that may result in coronary heart failure and stroke.
Hays and her colleagues on this research in contrast 80 sufferers with COVID-19 with 34 sufferers who didn’t have COVID-19 who have been additionally handled at The Johns Hopkins Hospital within the intensive or intermediate care models for respiratory points. None of the sufferers had a historical past of coronary heart arrhythmia.
Researchers analyzed echocardiograms of hospitalized sufferers, making use of a particular sort of evaluation known as speckle-tracking pressure to find out how properly the left atrium of the guts strikes with every heartbeat.
Patients with COVID-19 had decreased operate of their left atrium, the chamber of the guts that receives oxygenated blood from the lungs.
Left atrial pressure was considerably decrease in sufferers with COVID-19 and left atrial emptying fraction was additionally decrease within the sufferers with COVID-19.
Left atrial pressure was decrease among the many 30% of sufferers with COVID-19 who developed atrial fibrillation or flutter throughout their hospital keep in contrast with different sufferers with COVID-19. This means that speckle-tracking evaluation — and particularly, left atrial pressure measurement.
“A lot of patients already get echocardiograms while in the hospital; the addition of strain analysis requires no extra scanning of the patient,” says Erin Goerlich, M.D., a cardiology fellow on the Johns Hopkins University School of Medicine and first writer of the brand new paper.
“So this is a safe and affordable new data point that can clue us in about who might develop atrial fibrillation.” Echocardiograms price on common about $2,000, and are usually lined by medical insurance.
When the researchers seemed on the blood of sufferers with COVID-19 who developed atrial fibrillation, they noticed some variations in contrast with different sufferers with COVID-19. People who developed atrial fibrillation had larger ranges of troponin and NT-proBNP (946 versus 231, p=0.0007), two recognized markers of coronary heart stress.
“This tells us that COVID-19 patients with high levels of these biomarkers should be followed more closely and may benefit from an echocardiogram,” says Goerlich.
Hays cautioned that the present research did not check whether or not treating sufferers with COVID-19 with blood thinners may assist forestall the issues that may outcome from atrial fibrillation, which has been steered by some clinicians. Blood thinners are usually prescribed to atrial fibrillation sufferers to decrease the danger of blood clots and strokes.
New research means that treating folks with low left atrial pressure, may very well be one path ahead. More analysis is required on this space, Hays says.
“We’re also actively studying how these effects on the heart might persist after SARS-CoV-2 infection,” she provides. “It’s important to know whether those measures of strain and emptying fraction improve over time.”