Introduction
HRV indices
Echocardiographic evaluation
Patients and methods
Inclusion criteria
Exclusion criteria
2D Echocardiographic image acquisition and analysis of the LV-GLS [11]
Holter monitoring & HRV parameters
Statistics
Results
Number | |
---|---|
Age | 42.06 ± 18.51 |
Male sex | 38 (76%) |
Risk factors | |
Dm | 11 (22.0%) |
HTN | 12 (24.0%) |
Smoking | 8 (16.0%) |
Dyslipidemia | 4 (8.0%) |
Post covid symptoms | |
Chest pain | 8 (16%) |
Dyspnea | 27 (54%) |
Palpitations | 17 (34%) |
Dizziness | 7 (14%) |
Fatigue | 41 (82%) |
Echocardiographic data | Mean ± SD |
2D EF % | 62.62 ± 5.43 |
Modified Simpson's | 62.26 ± 4.98 |
MAPSE in cm | 1.37 ± 0.25 |
TAPSE in cm | 1.90 ± 0.20 |
LVEDD in mm | 47.60 ± 2.62 |
LVESD in mm | 27.62 ± 3.90 |
Aortic diameter(mm) | 24.50 ± 2.05 |
LA diameter (mm) | 32.34 ± 3.94 |
Diastolic dysfunction | |
No DD | 32 (64.0%) |
Grade I | 10 (20.0%) |
Grade II | 8 (16.0%) |
Grade III | 0 (0.0%) |
GLS in % | − 18.07 ± 2.48 |
Normal >—18% | 29 (58%) |
Grey zone − 16 to − 18% | 11 (22%) |
Diminished < − 16% | 10 (20%) |
Holter parameters | |
Max HR | 115.90 ± 16.86 |
Min HR | 57.64 ± 7.05 |
SDNN | 117.47 ± 24.66 |
SDANN | 102.24 ± 27 |
rMSSD (median) (IQR) | 30.9 (24.3–46.1) |
LF (median) (IQR) | 744.6 (326.6–1124) |
HF (median) (IQR) | 429 (161–682.5) |
LF/HF (median) (IQR) | 1.837 (0.8737–2.8999) |
Left ventricle Global Longitudinal Strain by Speckle Tracking Echocardiography and its correlation with the Holter parameters:
GLS | Test value | P-value | Sig | |||
---|---|---|---|---|---|---|
Normal | Gray zone | Diminished | ||||
No. = 29 | No. = 11 | No. = 10 | ||||
Demographic data: | ||||||
Age | 37.971• | 0.001 | HS | |||
Mean ± SD | 32.66 ± 10.92 | 41.45 ± 16.32 | 70.00 ± 6.83 | |||
Range | 18–60 | 26–66 | 64–80 | |||
Gender | 1.782* | 0.410 | NS | |||
Male | 23 (79.3%) | 9 (81.8%) | 6 (60.0%) | |||
Female | 6 (20.7%) | 2 (18.2%) | 4 (40.0%) | |||
CVS risk factors | ||||||
DM | 27.961* | 0.003 | HS | |||
No | 29 (100.0%) | 8 (72.7%) | 2 (20.0%) | |||
Yes | 0 (0.0%) | 3 (27.3%) | 8 (80.0%) | |||
HTN | 22.048* | 0.001 | HS | |||
No | 27 (93.1%) | 9 (81.8%) | 2 (20.0%) | |||
Yes | 2 (6.9%) | 2 (18.2%) | 8 (80.0%) | |||
Smoker | 0.263* | 0.877 | NS | |||
No | 25 (86.2%) | 9 (81.8%) | 8 (80.0%) | |||
Yes | 4 (13.8%) | 2 18.2%) | 2 (20.0%) | |||
Dyslipidaemia | 3.148* | 0.207 | NS | |||
No | 25 (86.2%) | 11 (100.0%) | 10 (100.0%) | |||
Yes | 4 (13.8%) | 0 (0.0%) | 0 (0.0%) | |||
Dyspnoea | 7.078* | 0.029 | s | |||
No | 17 (58.6%) | 5 (45.5%) | 1 (10.0%) | |||
Yes | 12 (41.4%) | 6 (54.5%) | 9 (90.0%) | |||
Holter parameters | ||||||
Max HR | ||||||
Mean ± SD | 118.66 ± 16.67 | 118.00 ± 15.66 | 105.60 ± 16.20 | 2.481• | 0.095 | NS |
Range | 88 – 148 | 89 – 134 | 90 – 127 | |||
Min HR | 4.163• | 0.022 | S | |||
Mean ± SD | 56.03 ± 6.43 | 57.00 ± 6.03 | 63.00 ± 7.80 | |||
Range | 43–67 | 49–66 | 55–76 | |||
SDNN | 13.170• | 0.001 | HS | |||
Mean ± SD | 122.19 ± 22.98 | 130.86 ± 15.92 | 89.04 ± 14.05 | |||
Range | 71.8–154.1 | 100.4–144.3 | 65–104.3 | |||
SDNN | 22.323* | 0.001 | HS | |||
Normal | 25 (86.2%) | 11 (100.0%) | 2 (20.0%) | |||
Impaired | 4 (13.8%) | 0 (0.0%) | 8 (80.0%) | |||
SDANN | 9.817• | 0.001 | HS | |||
Mean ± SD | 101.94 ± 28.59 | 124.12 ± 12.33 | 79.04 ± 10.98 | |||
Range | 56.7–142.6 | 100.2–135.9 | 61.5–93 | |||
rMSSD | 2.504‡ | 0.286 | NS | |||
Median (IQR) | 32.1 (27.4–49) | 27.9 (23.9–41.1) | 24.3 (22.5–44.9) | |||
Range | 17.6–190.6 | 22.6–49.1 | 18.3–67.1 | |||
LF | 21.574‡ | 0.110 | NS | |||
Median (IQR) | 744.6 (356 – 1135.7) | 1001.7 (921.8 – 1147.2) | 173.7 (92 – 326.4) | |||
Range | 111.1 – 1611.5 | 765 – 1206 | 24 – 331 | |||
HF | 10.475‡ | 0.296 | NS | |||
Median (IQR) | 429 (158.8–845.8) | 571.4 (489.3–850) | 161 (75.7–190.7) | |||
Range | 40.7–1963.6 | 316.9–987.5 | 28.2–543.8 | |||
LF/HF | 5.596‡ | 0.061 | NS | |||
Median (IQR) | 2.3194 (0.8737–4.37) | 1.8839 (1.0015–2.0077) | 0.8511 (0.6087–1.7116) | |||
Range | 0.1223–38.5504 | 0.9–3.1609 | 0.5714–2.2946 | |||
LF/HF | 5.621* | 0.229 | NS | |||
< 1.5 | 10 (34.5%) | 3 (27.3%) | 6 (60.0%) | |||
1.5–2 | 4 (13.8%) | 4 (36.4%) | 2 (20.0%) | |||
> 2 | 15 (51.7%) | 4 (36.4%) | 2 (20.0%) |
HRV indices and its correlation with risk factors, symptoms, and global longitudinal strain
SDNN | Test value | P- value | Sig | |||
---|---|---|---|---|---|---|
> 100 ms | < 100 ms | |||||
No. = 38 (76%) | No. = 12 (24%) | |||||
Age | Mean ± SD | 37.18 ± 15.33 | 57.50 ± 19.87 | -3.723• | 0.001 | HS |
Range | 18–71 | 24–80 | ||||
Gender | Male | 32 (84.2%) | 6 (50.0%) | 5.852* | 0.016 | S |
Female | 6 (15.8%) | 6 (50.0%) | ||||
CVS risk factors: - | ||||||
DM | No | 33 (86.8%) | 6 (50.0%) | 7.214* | 0.007 | HS |
Yes | 5 (13.2%) | 6 (50.0%) | ||||
HTN | No | 32 (84.2%) | 6 (50.0%) | 5.852* | 0.016 | S |
Yes | 6 (15.8%) | 6 (50.0%) | ||||
Smoker | No | 32 (84.2%) | 10 (83.3%) | 0.005* | 0.942 | NS |
Yes | 6 (15.8%) | 2 (16.7%) | ||||
Dyslipidaemia | No | 36 (94.7%) | 10 (83.3%) | 1.611* | 0.204 | NS |
Yes | 2 (5.3%) | 2 (16.7%) | ||||
Palpitations | No Yes | 29 (76.3%) 9 (23.7%) | 4 (33.3%) 8 (66.7%) | 7.509* | 0.006 | HS |
Holter parameters | ||||||
2D EF | Mean ± SD | 63.29 ± 5.41 | 60.50 ± 5.14 | 1.575• | 0.122 | NS |
Range | 50 – 72 | 55 – 70 | ||||
Simpson's | Mean ± SD | 62.87 ± 5.14 | 60.33 ± 4.03 | 1.561• | 0.125 | NS |
Range | 52 – 70 | 54 – 66 | ||||
DD | No DD | 28 (73.7%) | 4 (33.3%) | 9.430* | 0.912 | NS |
Grade I Grade II | 4 (10.5%) 6 (15.8%) | 6 (50.0%) 2 (16.7%) | ||||
MAPSE | Mean ± SD | 1.41 ± 0.22 | 1.25 ± 0.30 | 2.034• | 0.471 | NS |
Range | 1 – 1.9 | 0.8 – 1.5 | ||||
TAPSE | Mean ± SD Range | 1.96 ± 0.19 1.7 – 2.4 | 1.73 ± 0.10 1.6 – 1.9 | 3.816• | 0.973 | NS |
GLS | Mean ± SD | -18.81 ± 1.95 | -15.74 ± 2.61 | -4.379• | 0.001 | HS |
Range | -15.3 – -22.8 | -11.7 – -19 | ||||
GLS | Normal | 25 (65.8%) | 4 (33.3%) | 22.323* | 0.001 | HS |
Gray zone | 11 (28.9%) | 0 (0.0%) | ||||
Diminished | 2 (5.3%) | 8 (66.7%) |