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ISSN 2522-9028 (Print)
ISSN 2522-9036 (Online)
DOI: https://doi.org/10.15407/fz

Fiziologichnyi Zhurnal

(English title: Physiological Journal)

is a scientific journal issued by the

Bogomoletz Institute of Physiology
National Academy of Sciences of Ukraine

Editor-in-chief: V.F. Sagach

The journal was founded in 1955 as
1955 – 1977 "Fiziolohichnyi zhurnal" (ISSN 0015 – 3311)
1978 – 1993 "Fiziologicheskii zhurnal" (ISSN 0201 – 8489)
1994 – 2016 "Fiziolohichnyi zhurnal" (ISSN 0201 – 8489)
2017 – "Fiziolohichnyi zhurnal" (ISSN 2522-9028)

Fiziol. Zh. 2025; 71(2): 40-50


Influence of Plasma Hemostasis on Intracardiac Hemodynamics in Patients with Chronic Coronary Heart Disease and COVID-19

V.Z. Netiazhenko1,3, S.E. Mostovyi1,2, M.M. Zhaivoronok1,4

  1. Bogomolets National Medical University, Kyiv, Ukraine
  2. SE “Medbud”, Kyiv, Ukraine
  3. State Institution of Science “Center of innovative healthcare technologies” State Administrative Department, Ukraine
  4. P. L. Shupyk National Healthcare University of Ukraine, Ukraine
DOI: https://doi.org/10.15407/fz71.02.040


Abstract

In COVID-19 coronavirus disease, plasma hemostasis dysfunction and intracardiac hemodynamics (ICH) are observed, which increase the risk of thromboembolic complications and cardiovascular events. The aim of our study was to investigate the impact of COVID-19 on the interdependence of changes in the plasma hemostasis system and intracardiac hemodynamics in patients with chronic coronary artery disease (CHD). We analyzed the laboratory and instrumental results of 386 patients who were divided into 3 groups: Group 1 - CHD without COVID-19 (n = 79); Group 2 - CHD in combination with COVID-19 (n = 127); Group 3 - COVID-19 without CHD (n = 180). The control group included 37 conditionally healthy volunteers. Changes in plasma hemostasis were studied using an automatic blood coagulation analyzer K 3002 OPTIS (KSELMED), Poland. Echocardiography was performed on the HDI 11XE and MyLabXE8 XP. In patients with chronic coronary artery disease with concomitant COVID-19, a wide range of plasma hemostatic disorders were observed, including increased levels of soluble fibrin monomer complexes, XII-a (Hageman) dependent fibrinolysis, and decreased levels of protein C and antithrombin III. The profile of CHD in combination with COVID-19, in contrast to the “isolated” passing of both conditions, was characterized by a more pronounced disturbance of intracardiac hemodynamics. Patients with chronic coronary artery disease, in particular in combination with COVID-19, showed signs of left and right ventricular remodeling and increased systolic pressure in the pulmonary artery according to echocardiography. Patients with chronic coronary artery disease who have had COVID-19 have a more pronounced activation of plasma hemostasis compared to patients with coronary artery disease alone or COVID-19. COVID-19 contributes to the deterioration of left ventricular systolic function and left ventricular remodeling in patients with chronic CHD, which correlates with fibrinogen and protein C and antithrombin III levels. Increased systolic pressure in the pulmonary artery and right ventricular dilatation in patients with CHD and COVID-19 may indicate the development of pulmonary hypertension and an increased risk of right ventricular failure. Thus, patients with chronic CHD and concomitant COVID-19 along with dysfunction of the plasma hemostasis system showed signs of intracardiac hemodynamics of the left ventricle. Additional consideration of the characteristics of plasma hemostasis and intracardiac hemodynamics is advisable in managing such patients.

Keywords: chronic coronary heart disease; COVID-19; intracardiac hemodynamics; left ventricular systolic function, plasma hemostasis.

References

  1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China. 2019. N Engl J Med. 2020 CrossRef PubMed PubMedCentral 382(8): 727-33. doi: 10.1056/NEJMoa2001017. Epub 2020 Jan 24.
  2. Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. N Engl J Med. 2020; 383(2): 120-8. doi: CrossRef PubMed PubMedCentral 10.1056/NEJMoa2015432. Epub 2020 May 21.
  3. Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med. 2017; 2017 Aug 10;377(6):562-72. doi: 10.1056/NEJMra1608077. CrossRef PubMed
  4. Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and multi-organ response. Curr Probl Cardiol. 2020; 45(8): 100618. PMID: 32439197 doi: 10.1016/j.cpcardiol.2020.100618 CrossRef PubMed PubMedCentral
  5. Schulman S, Hu Y, Konstantinides S. Venous thromboembolism in COVID-19. Thromb Haemostas. 2020; 120 (12): 1642-53. doi: 10.1055/s-0040-1718532 CrossRef PubMed PubMedCentral
  6. Katneni UK, Alexaki A, Hunt RC, Schiller T. Coagulopathy and thrombosis as a result of severe COVID-19 infection: A microvascular focus. Thromb Haemostas. 2020; 120(12): 1668-79. doi: 10.1055/s-0040-1715841 CrossRef PubMed PubMedCentral
  7. Conti P, Ronconi G, Caraffa A, Gallenga C, Ross R, Frydas I, Kritas S. Induction of pro-inflammatory cytokines (IL1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): Anti-inflammatory strategies. J Biol Regul Homeost Agent. 2020;34(2):327-31. doi: 10.23812/CONTI-E. CrossRef PubMed
  8. Sayyadi M, Hassani S, Shams M, Dorgalaleh A. Status of major hemostatic components in the setting of COVID-19: the effect on endothelium, platelets, coagulation factors, fibrinolytic system, and complement. Ann Hematol. 2023 102:1307-22. CrossRef CrossRef PubMed PubMedCentral
  9. Anna Kalinskaya, et al. Targeted blood plasma proteomics and hemostasis assessment of post COVID-19 patients with acute myocardial infarction. Int J Mol Sci. 2023, 24, 6523. CrossRef CrossRef PubMed PubMedCentral
  10. Shari R Waldstein, Willem J Kop, Edward C Suarez, William R Lovallo, Leslie I Katzel. Handbook of cardiovascular behavioral medicine. New York: Springer; 2021. Сhapter 2. Section ІІ: Hemostasis and Endothelial Function. p. 861-90. CrossRef
  11. Zolotukhina Y.O. Fibrinolytic activity of blood in patients with coronary heart disease and concomitant type 2 diabetes mellitus. Ukr Med J. 2018;6(128):1-3. DOI: 10.32471/umj.1680-3051.128.134557 [Ukrainian].
  12. Krasnova AA, Ignatko YA, Derbak MA, Rishko OA. Features of the course of chronic coronary heart disease in the context of the COVID-19 pandemic (literature review). Probl Clin Pediatr. 2022;4 (58):.6-11. DOI: 10.24144/1998-6475.2022.58.6-11. [Ukrainian].
  13. Iba T, Levy JH, Levi M, Thachil J. (2020) Coagulopathy in COVID-19. J. Thromb. Haemost., 18(9): 2103-2109. J Thromb Haemost. 2020 Sep;18(9):2103-9. doi: 10.1111/jth.14975 CrossRef PubMed PubMedCentral
  14. Lip GYH, Blann AD, et al. Fibrinogen and fibrin D-dimer in cardiovascular disease: Determinants and implications. J Am College Cardiol. 1998; 31(7): 1427- DOI:10.1016/S0735-1097(98)00128-8.
  15. Libby P, Lüscher T. «COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020; 41(32): 3038-44. DOI:10.1093/eurheartj/ehaa623. CrossRef PubMed PubMedCentral
  16. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020;38(7):1504-7. DOI:10.1016/j.ajem.2020.04.048. CrossRef PubMed PubMedCentral
  17. Vilahur G, Fuster V, Ibanez B. Pathogenesis of coronary thrombosis and myocardial infarction. In: Fuster V, Narula J, Vaishnava P, Leon MB, Callans DJ, Rumsfeld JS, Poppas A, editors. Fuster and Hurst's The Heart. McGraw-Hill Education; 2022.
  18. Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-40. doi:10.1016/S2352-3026(20)30145-9 CrossRef PubMed
  19. Zeng JH, Liu YX, Yuan J, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection. 2020;48(5):773-7. doi:10.1007/s15010-020-01424-5. CrossRef PubMed PubMedCentral
  20. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. doi:10.1111/jth.14768. CrossRef PubMed PubMedCentral
  21. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95(7):834-47. doi:10.1002/ajh.25829 CrossRef PubMed PubMedCentral
  22. Petersen SE, Friedrich MG, Leiner T, Elias MD, Ferreira VM, Fenski M, et al. Cardiovascular magnetic resonance for patients with COVID-19, JACC: Cardiovascul Imag. 2022;15(4): 685-99. CrossRef CrossRef PubMed PubMedCentral
  23. Hudák A, Pusztai D, Letoha A, Letoha T. Mutual inhibition of antithrombin III and SARS-CoV-2 cellular attachment to syndecans: Implications for COVID-19 treatment and vaccination. Int J Mol Sci. 2024; 25(14):7534. CrossRef CrossRef PubMed PubMedCentral
  24. Griffin JH, Lyden P. COVID-19 hypothesis: Activated protein C for therapy of virus-induced pathologic thromboinflammation. Res Pract Thromb Haemost. 2020;4(4):506-9. doi:10.1002/rth2.12362 CrossRef PubMed PubMedCentral
  25. Hvas CL, Larsen JB. The fibrinolytic system and its measurement: history, current uses and future directions for diagnosis and treatment. Int J Mol Sci. 2023; 24(18):14179. CrossRef CrossRef PubMed PubMedCentral
  26. Mann KG, Brummel K, Butenas S. What is all that thrombin for? J Thromb Haemost. 2003;1(7):1504-14. doi:10.1046/j.1538-7836.2003.00298.x CrossRef PubMed
  27. Grobler C, Maphumulo SC, Grobbelaar LM, et al. Covid-19: The rollercoaster of fibrin(ogen), d-dimer, von willebrand factor, p-selectin and their interactions with endothelial cells, platelets and erythrocytes. Int J Mol Sci. 2020;21(14):5168. doi:10.3390/ijms21145168. CrossRef PubMed PubMedCentral

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