Peripartāla kardiomiopātija un tas ietekme uz aritmiju attīstību
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Peripartāla kardiomiopātija (PPKM) ir dzīvību apdraudējošs stāvoklis grūtniecības periodā, kas parasti attīstas 3 grūtniecības trimestrī vai arī līdz 5 mēnēšiem pēcdzemdību periodā. Slimība prezentējas ar kreisā sirds kambara dilatāciju, akūto sirds mazspēju, ventrikulāram aritmijam un/vai sirds apstašanos. Vides un ģenētiskiem riska faktoriem ir liela lomā slimību predispozīcijā. COVID-19 infekcija mūsdienās var ietekmēt PPKM attistību kā jauns, nozīmīgs riska faktors.
Darba raksturojums un mērķi: Identificēt PPKM ar/bez aritmijas incidenci Latvijā pirms un pēc pandēmijas periodā, ka arī identificēt iespējāmo gadījumu skaita pieaugumu pandemijas periodā, salīdzinājuma ar pirmspandemijas periodu. Noteikt vidējo riska faktoru daudzumu PPKM augsta riska grupas klasifikācijai. Izveidot statistisku PPKM incidenci Latvijā. Izpētīt COVID-19 infekcijas ietekmi uz PPKM attistību.
Metodes: Sekundārs kvantitatīvs pētījums Paula Stradiņa klīniskas universitātes slimnīcas medicīniskā arhīva datiem; Literatūras analīze izmantojot pasaules datubāzes, vadlīnijas, publikācijas. Datu analīze Microsoft® Excel® for Microsoft 365 MSO (version 2201 16.0.14827.20198) 64-bit parlūkprogrammā.
Rezultāti: No izvelēta laika perioda 800 vēsturem tiek atlasītas 22 vēstures datu analīzei. Vidējais pacientu vecums ir 33 ±5 gadi. Pacientēm ar apstiprinātu PPKM vecums ir 39 ±5 (n=4), vecums atbilsts nosacītam riska faktoram un ir >30 gadiem; 9 pacientem tiek veikta ehokardiogrāfijas izmeklējums (40,9%); Sievietem ar apstiprinātu Vīdējais LVEF pacientem ar PPKM ir 45,8% ±4,3; vidējais LVEF no visiem 9 pieejāmiem ECHO izmeklējumiem sastadīja 55% ± 0,09. 1 no 22 gadījumiem pacientei dzemdību laikā attistījusies akūta sirds mazspēja, kas terminējas ar klīnisko nāvi un kardio-pulmonālu reanimāciju. Aritmija ir attistījusies 2 (9%) no kopēja pacientu skaita. Tromboembolijas epizodes konstatētas 4 (16%) gadījumu. 1 (4%) gadījuma ir konstatēta stāvokļa uzlabošanas no PPKM. Sākot ar 11.03.2019 netika diagnosticēts PPKM gadījumu pieaugums salīdzīnot ar periodu līdz 11.03.2019. Nevienai no pētijuma analizētam sievietem netika diagnosticēts COVID-19 infekcija. Vidējais riska faktoru daudzums attiecība uz augsta PPKM attistības risku ir 3+ faktoru daudzums.
Secinājumi: Augsta PPKM incidence ir pie 3+ riska faktoru esamības. Esošie analizējamie dati nepieradīja COVID-19 infekcijas būtisku ietekmi uz PPKM attistību, ka arī aritmījas attistību vai sirds apstašanos. PPKM prevalence Latvijā (0,01%) atbilst incidences datiem pasaulē (<0,1%).
SUMMARY Background: Peripartum cardiomyopathy is a life-threatening condition in pregnancy, that occurs in 3rd trimester of pregnancy or 5 months after delivery, presenting with a heart left ventricular pathologies, acute heart failure, ventricular arrhythmias and/or cardiac arrest. Predisposition is caused by environmental and/or genetic factors. COVID-19 infection related as a new risk factor predisposing or developing illness condition. Characteristics and aim: The aim is to identify PPCM with/without arrhythmia incidence and an increase in a number of cases in Latvia comparing pre-COVID and post-COVID data. Qualify the average quantum of risks factors for a high-risk group of PPCM development. Create a statistical report of PPCM patients in Latvia. Investigate COVID-19 infection impact on PPCM development and increment of PPCM incidence in Latvia. Methods: Secondary quantitative research using Paul Stradins university hospital medical data archive. Literature research on PPCM using abstracts, reports, journals, PubMed databases, ESC guidelines 2018. Data analysis via Microsoft® Excel® for Microsoft 365 MSO (version 2201 16.0.14827.20198) 64-bit Results: From 800 total cases 22 were selected for a study. Mean age was 33 ±5 years; 9 patients had an ECHO cardiography (40,9% of cases). Mean LVEF was 45,8% ±4,3 (n=4) for women with PPCM, mean overall LVEF was 55% ± 0,09 (n=9). 1 (4%) case had average 5-month mortality of 100% with cardial death and successful resuscitation. Arrhythmia occurred in 2 (9%) of cases. Thromboembolic events occurred in 4 cases (16%). Recovery occurred in 1 (4%) of all approved PPCM cases. No significant data of PPCM increasing rates were stated from 11.03.2019; None of analyzed patients had a registered COVID-19 infection. The average quantum of risks factors is 3+ for inclusion in a high-risk group of PPCM development. Conclusion: PPCM occurs with 3+ risk factors. No significant data showed a strong impact of COVID infection in development of PPCM, as well as related arrhythmia and cardiac arrest. The prevalence of PPCM in Latvia (0,01%) corresponds with average world incidence of PPCM cases (<0,1%).
SUMMARY Background: Peripartum cardiomyopathy is a life-threatening condition in pregnancy, that occurs in 3rd trimester of pregnancy or 5 months after delivery, presenting with a heart left ventricular pathologies, acute heart failure, ventricular arrhythmias and/or cardiac arrest. Predisposition is caused by environmental and/or genetic factors. COVID-19 infection related as a new risk factor predisposing or developing illness condition. Characteristics and aim: The aim is to identify PPCM with/without arrhythmia incidence and an increase in a number of cases in Latvia comparing pre-COVID and post-COVID data. Qualify the average quantum of risks factors for a high-risk group of PPCM development. Create a statistical report of PPCM patients in Latvia. Investigate COVID-19 infection impact on PPCM development and increment of PPCM incidence in Latvia. Methods: Secondary quantitative research using Paul Stradins university hospital medical data archive. Literature research on PPCM using abstracts, reports, journals, PubMed databases, ESC guidelines 2018. Data analysis via Microsoft® Excel® for Microsoft 365 MSO (version 2201 16.0.14827.20198) 64-bit Results: From 800 total cases 22 were selected for a study. Mean age was 33 ±5 years; 9 patients had an ECHO cardiography (40,9% of cases). Mean LVEF was 45,8% ±4,3 (n=4) for women with PPCM, mean overall LVEF was 55% ± 0,09 (n=9). 1 (4%) case had average 5-month mortality of 100% with cardial death and successful resuscitation. Arrhythmia occurred in 2 (9%) of cases. Thromboembolic events occurred in 4 cases (16%). Recovery occurred in 1 (4%) of all approved PPCM cases. No significant data of PPCM increasing rates were stated from 11.03.2019; None of analyzed patients had a registered COVID-19 infection. The average quantum of risks factors is 3+ for inclusion in a high-risk group of PPCM development. Conclusion: PPCM occurs with 3+ risk factors. No significant data showed a strong impact of COVID infection in development of PPCM, as well as related arrhythmia and cardiac arrest. The prevalence of PPCM in Latvia (0,01%) corresponds with average world incidence of PPCM cases (<0,1%).
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Kardiomiopātija; grūtniecība; aritmija; COVID-19, Cardiomyopathy; Pregnancy; Arrhythmia; COVID-19