Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome - a case-control study.
Impaired parasympathetic function in long-COVID postural orthostatic tachycardia syndrome - a case-control study.
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DOI：
10.1186/s42234-023-00121-6
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发表时间：
2023-09-06
影响因子：
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通讯作者：
Shibao, Cyndya A
中科院分区：
文献类型：
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作者：
Rigo, Stefano;Urechie, Vasile;Diedrich, Andre;Okamoto, Luis E;Biaggioni, Italo;Shibao, Cyndya A
80%感染SARS-CoV-2的患者报告一种症状在4周恢复期后持续存在。那些有体位性心动过速和类似体位性心动过速综合征的体位症状的人被定义为长covid POTS [LCP]。本病例对照研究调查了LCP患者和健康对照者之间自主心血管调节的潜在差异。13名LCP和16名健康对照，均为女性受试者，在不服用药物的情况下进行研究。记录体位压力试验、呼吸性窦性心律失常和Valsalva手法时的连续血压和心电图。计算心率[HR]和收缩压[SBP]变异性的时域和功率谱分析，表征心脏自主控制和交感周围血管收缩。连结控制协定deltaHR较高(+ 40±6 vs + 21±3 bpm, p = 0.004)和deltaSBP(+ 8±4和1±2毫米汞柱,p = 0.04)站;47%的患者Valsalva机动率受损，对照组为6.2% （p = 0.01）。光谱分析显示，LCP的RMSSD（32.1±4.6 vs 48.9±6.8 ms, p = 0.04）和HFRRI的绝对值（349±105 vs 851±253ms2, p = 0.03）和归一化单位（32±4 vs 46±4 n.u, p = 0.02）均较低。两组间LFSBP相似。LCP降低了心血管调节功能，但交感心脏和血管收缩功能正常。副交感神经功能受损可能与长冠综合征的发病机制有关。
Eighty percent of patients infected by SARS-CoV-2 report persistence of one symptom beyond the 4-week convalescent period. Those with orthostatic tachycardia and orthostatic symptoms mimicking postural tachycardia syndrome, they are defined as Long-COVID POTS [LCP]. This case-control study investigated potential differences in autonomic cardiovascular regulation between LCP patients and healthy controls. Thirteen LCP and 16 healthy controls, all female subjects, were studied without medications. Continuous blood pressure and ECG were recorded during orthostatic stress test, respiratory sinus arrhythmia, and Valsalva maneuver. Time domain and power spectral analysis of heart rate [HR] and systolic blood pressure [SBP] variability were computed characterizing cardiac autonomic control and sympathetic peripheral vasoconstriction. LCP had higher deltaHR (+ 40 ± 6 vs. + 21 ± 3 bpm, p = 0.004) and deltaSBP (+ 8 ± 4 vs. -1 ± 2 mmHg, p = 0.04) upon standing; 47% had impaired Valsalva maneuver ratio compared with 6.2% in controls (p = 0.01). Spectral analysis revealed that LCP had lower RMSSD (32.1 ± 4.6 vs. 48.9 ± 6.8 ms, p = 0.04) and HFRRI, both in absolute (349 ± 105 vs. 851 ± 253ms2, p = 0.03) and normalized units (32 ± 4 vs. 46 ± 4 n.u., p = 0.02). LFSBP was similar between groups. LCP have reduced cardiovagal modulation, but normal sympathetic cardiac and vasoconstrictive functions. Impaired parasympathetic function may contribute to the pathogenesis of Long-COVID POTS syndrome.