目的:确定心血管系统的临床变化,和结构,切尔诺贝利核电站(CNNP)事故的紧急救援人员(EW)的功能状态可能与他们遭受的COVID-19有关,而与冠心病(CHD)的自然进展无关。
方法:该研究包括16名男性EW,他们在2020-2021年因轻度和中度COVID-19(EWC组)患病,并通过PCR测试(聚合酶链反应)证实。所有这些患者都是在感染冠状病毒之前在NRCRM心脏科观察到的。对照组由32名EW组成,他们没有患有COVID-19,他们的年龄和检查日期与EWC相对应。一般临床,实验室,采用统计学方法和多普勒超声心动图对患者进行检查。
结果:在后covid时期,EW-C观察到冠心病临床病程恶化,其中包括严重功能性心绞痛患者数量的增加,室性早搏和室上性早搏,以及更严重的心力衰竭(HF)。由于在未患有COVID-19的EW中发现了心血管系统状态的类似变化,因此它们可以归因于冠心病的自然进展。在EW-C组中,房颤(AF)患者的数量增加了4倍(增加了37.5%),而在对比组中EW仅增长了1.1倍(上升3.1%)。在被检查的患者中,CHD和HF的进展伴随着左心室的舒张末期和收缩末期体积的增加以及心肌的质量。有和没有COVID-19的患者的严重程度没有显着差异。COVID-19后检查中射血分数(EF)降低的患者数量增加了31.3%,在EW组中,同时检查,6.32%。
结论:与EW相比,EW-C的房颤患者数量显着增加,EF降低,这可以归因于SARS-CoV-2病毒对心血管系统的影响。
Meta:vyznachyty,iakizminyklinichnogotastrukturno-funktopic\'nogostanusertsevo-sudynoidesystemymozhnapov'iazatyizperenesenymmCOVID-19,aneprydonynymprogresusvanniamishnichnoketyserMaterialytaMetody.Dodoslidzhenniauvishly16ULNAcholovichoístati,iakiu2020-2021rokakhperekhvorilynalegkytaseredn\'o-tiazhkycovid-19(grupaULNA-K),iakiabuvpidtverdzhenyPLR-stomm(polimmeraznalantsiugovareaktsiia).VsitsipatsientydozarazhenniakoronavirusomspasterigalysiauviddilennikardiologiíNNTsRMzpryvoduIKhs.Grupuporivnianniaskladaly32ULNA,iakinekhvorilynaCOVID-19,ta_khnikistrokyobstezen\'vidpovidalyULNA-K.Pryobstezhennikhvorykhvykorystovuvalyzagal\'noklinichni,实验室,statystychnimetodytadopplerekhokardiografiiu。Rezul\'taty.UpostkovidnomuperidivULNA-KspasterigalosiapogirshenniaklinichnogoperebiguIKhs,shchopoliagalouzbil\'shennikil\'kostipatsiientivzistenokardiieunaprugytiazhkogofunktitional\'nogoklasu,zventrykuliarnymyisuppraventrykuliarnymyekstrasystolamy,atakozhzbil\'shtiazhkoiusertsevoiunedostatnistiu(SN)。Oskil\'kyseredULNA,iakinekhvorilynaCOVID-19,vyiavlenoanalogichnizminystanusertsevo-sudynoidesystemy,致伊克赫莫兹纳特赦组织扎·拉赫努克·普罗诺戈·普罗格尼亚·艾克斯。VgrupiULNA-Kvidznachalosiazbil\'shenniakil\'kostipatsiientvzfiryliatsiieuperedserd\'(FP)u4razy(na37,5%),托迪·艾克诉格鲁比·波里维尼亚尼亚·莱舍诉1,1拉扎(na3,1%)。ProgresuvanniaIKhstaSNvobstezhenykhpatsiientivsuppetridzhuvalosiazbil\'shenniamkintsevo-distonolichnogotakintsevo-systolichnogoob'iemivliogoshlunochkatamasymikarda,vyrazhenist\'iakogodostovirnonevidriznialas\'upatsiientiv,iakiKhvorilytaneKhvorilynaCOVID-19。Kil\'kist\'postkovidnykhpatsiientivziznyzhenoiufraktsieiuvykydu(FV)撬动obstezhennipisliaCOVID-19zroslana31,%,vgrupiULNA,iakibulyobstezhenivtakizhterminy,na6,32%。Vysnovky.Dostovirnezbil\'shenniavidnosogochyslapatsiientivzFPtaznyzhenoiuFVvULNA-KporivnianozULNAmozhnavidnestydorezul\'tativvvvvvvvvirusuSARS-CoV-2nertsersevo-
OBJECTIVE: to determine which changes of cardiovascular system clinical, and structural, and functional state in emergency workers (EW) of the accident at the Chornobyl nuclear power plant (CNNP) can be associated with COVID-19 they suffered from and not with the natural progression of coronary heart disease (CHD).
METHODS: The study included 16 male EW who fell ill with mild and medium-severe COVID-19 (EWC group) in 2020-2021, which was confirmed by a PCR test (polymerase chain reaction). All these patients were observed in the NRCRM cardiology department before infection with the coronavirus. The comparison group consisted of 32 EW who did not suffer from COVID-19 and their age and examination dates corresponded to EWC. General clinical, laboratory, statistical methods and Doppler echocardiography were used for patients examination.
RESULTS: In the post-covid period, EW-C observed a worsening of CHD clinical course, which consisted in an increase in the number of patients with severe functional class angina pectoris, with ventricular and supraventricular extrasystoles, as well as with more severe heart failure (HF). Since similar changes in the state of the cardiovascular system were found among EW who did not suffer from COVID-19, they can be attributed to the natural progression of CHD. In the EW-C group, there was an increase in the number of patients with atrial fibrillation (AF) by 4 times (up 37.5 %), while in the comparison group EW only by 1.1 times (up 3.1 %). The progression of CHD and HF in the examined patients was accompanied by an increase in the end-diastolic and end-systolic volumes of the left ventricle and the mass of the myocardium, the severity of which was not significantly different in patients with and without COVID-19. The number of post-covid patients with reduced ejection fraction (EF) during examination after COVID-19 increased by 31.3 %, and in the group of EW, which were examined at the same time, by 6.32 %.
CONCLUSIONS: A significant increase in the number of patients with AF and a reduced EF in the EW-C compared with the EW can be attributed to the results of the SARS-CoV-2 virus influence on cardiovascular system.
Meta: vyznachyty, iaki zminy klinichnogo ta strukturno-funktsional\'nogo stanu sertsevo-sudynnoï systemy mozhna pov’iazaty iz perenesenym COVID-19, a ne pryrodnym progresuvanniam ishemichnoï khvoroby sertsia (IKhS) v uchasnykiv likvidatsiï naslidkiv avariï (ULNA) na Chornobyl\'s\'kiĭ atomniĭ elektrostantsiï.Materialy ta metody. Do doslidzhennia uviĭshly 16 ULNA cholovichoï stati, iaki u 2020–2021 rokakh perekhvorily na legkyĭ ta seredn\'o-tiazhkyĭ COVID-19 (grupa ULNA-K) , iakiĭ buv pidtverdzhenyĭ PLR-testom (polimerazna lantsiugova reaktsiia). Vsi tsi patsiienty do zarazhennia koronavirusom sposterigalysia u viddilenni kardiologiï NNTsRM z pryvodu IKhS. Grupu porivniannia skladaly 32 ULNA, iaki ne khvorily na COVID-19, ta ïkhniĭ vik i stroky obstezhen\' vidpovidaly ULNA-K. Pry obstezhenni khvorykh vykorystovuvaly zagal\'noklinichni, laboratorni, statystychni metody ta dopplerekhokardiografiiu. Rezul\'taty. U postkovidnomu periodi v ULNA-K sposterigalosia pogirshennia klinichnogo perebigu IKhS, shcho poliagalo u zbil\'shenni kil\'kosti patsiientiv zi stenokardiieiu naprugy tiazhkogo funktsional\'nogo klasu, z ventrykuliarnymy i supraventrykuliarnymy ekstrasystolamy, a takozh z bil\'sh tiazhkoiu sertsevoiu nedostatnistiu (SN). Oskil\'ky sered ULNA, iaki ne khvorily na COVID-19, vyiavleno analogichni zminy stanu sertsevo-sudynnoï systemy, to ïkh mozhna vidnesty za rakhunok pryrodnogo progresuvannia IKhS. V grupi ULNA-K vidznachalosia zbil\'shennia kil\'kosti patsiientiv z fibryliatsiieiu peredserd\' (FP) u 4 razy (na 37,5 %), todi iak v grupi porivniannia lyshe v 1,1 raza (na 3,1 %).Progresuvannia IKhS ta SN v obstezhenykh patsiientiv suprovodzhuvalosia zbil\'shenniam kintsevo-diastolichnogo ta kintsevo-systolichnogo ob’iemiv livogo shlunochka ta masy miokarda, vyrazhenist\' iakogo dostovirno ne vidriznialas\' u patsiientiv, iaki khvorily ta ne khvorily na COVID-19. Kil\'kist\' postkovidnykh patsiientiv zi znyzhenoiu fraktsiieiu vykydu (FV) pry obstezhenni pislia COVID-19 zrosla na 31,3 %, a v grupi ULNA, iaki buly obstezheni v taki zh terminy, na 6,32 %. Vysnovky. Dostovirne zbil\'shennia vidnosnogo chysla patsiientiv z FP ta znyzhenoiu FV v ULNA-K porivniano z ULNA mozhna vidnesty do rezul\'tativ vplyvu virusu SARS-CoV-2 na sertsevo-sudynnu systemu.