Key result
Increased HRV and CK-MB linked to greater odds of post-COVID-19 palpitations and chest pain.
Why the study?
The study was conducted to evaluate 24-hour ambulatory ECG recordings, autonomic function using heart rate variability, and silent ischemia attacks in post-COVID-19 patients.
Are autonomic dysfunction and silent ischemia more prevalent in symptomatic post-COVID-19 patients compared to asymptomatic post-COVID-19 patients?
Observational (n=128)
Single-blind
No
Are autonomic dysfunction and silent ischemia more prevalent in symptomatic post-COVID-19 patients compared to asymptomatic post-COVID-19 patients?
Odds Ratio: 1.033 (95% CI 1.005–1.061)
p-value: p=0.019
Symptomatic post-COVID-19 patients with palpitations and chest pain demonstrate increased silent ischemia and altered heart rate variability on 24-hour ambulatory ECG compared to asymptomatic patients.
May support ECG monitoring in symptomatic post-COVID patients; leaves open causal roles of autonomic dysfunction and silent ischemia.
INTRODUCTION AND OBJECTIVE: In this context, the objective of this study is to evaluate the 24-hour ambulatory electrocardiography (ECG) recordings, autonomous function with heart rate variability (HRV), and silent ischemia (SI) attacks with ST depression burden (SDB) and ST depression time (SDT) of post-COVID-19 patients. Materials and methods: The 24-hour ambulatory ECG recordings obtained >12 weeks after the diagnosis of COVID-19 were compared between 55 consecutive asymptomatic and 73 symptomatic post-COVID-19 patients who applied to the cardiology outpatient clinic with complaints of palpitation and chest pain in comparison with asymptomatic post-COVID-19 patients in Kars Harakani state hospital. SDB, SDT, and HRV parameters were analyzed. Patients who had been on medication that might affect HRV, had comorbidities that might have caused coronary ischemia, and were hospitalized with severe COVID-19 were excluded from the study. RESULTS: There was no significant difference between symptomatic and asymptomatic post-COVID-19 patients in autonomic function. On the other hand, SDB and SDT parameters were significantly higher in symptomatic post-COVID-19 patients than in asymptomatic post-COVID-19 patients. Multivariate analysis indicated that creatine kinase-myoglobin binding (CK-MB) (OR:1.382, 95% CI:1.043-1.831; p=0.024) and HRV index (OR: 1.033, 95% CI:1.005-1.061; p=0.019) were found as independent predictors of palpitation and chest pain symptoms in post-COVID-19 patients. CONCLUSION: The findings of this study revealed that parasympathetic overtone and increased HRV were significantly higher in symptomatic patients with a history of COVID-19 compared to asymptomatic patients with a history of COVID-19 in the post-COVID-19 period. Additionally, 24-hour ambulatory ECG recordings and ST depression analysis data indicated that patients who experienced chest pain in the post-COVID-19 period experienced silent ischemia (SI) attacks.
No takes yet. Share an insight, caveat, or question.
Karakayalı et al. (2023) conducted an observational in Post-COVID-19 syndrome (n=128). Post-COVID-19 symptoms (chest pain and palpitations) vs. Asymptomatic post-COVID-19 patients was evaluated on Palpitation and chest pain symptoms (predicted by HRV index) (OR 1.033, 95% CI 1.005-1.061, p=0.019). Increased heart rate variability index (OR 1.033) and CK-MB levels (OR 1.382) were identified as independent predictors of palpitation and chest pain symptoms in post-COVID-19 patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: