IMR Press / RCM / Volume 24 / Issue 2 / DOI: 10.31083/j.rcm2402051
Open Access Review
Features of Atrial Fibrillation Pathogenesis and Prognosis in Chronic Obstructive Pulmonary Patients during the COVID-19 Pandemic
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1 Department of Cardiology, Yerevan State Medical University named after Mkitar Heratsi, 0025 Yerevan, Armenia
2 Department of Arrhythmias, Scientific Research Institute of Cardiology named after Levon Hovhannisyan, 0014 Yerevan, Armenia
*Correspondence: s.grigoryan@interdiagnostika.com (Svetlana V. Grigoryan)
Rev. Cardiovasc. Med. 2023, 24(2), 51; https://doi.org/10.31083/j.rcm2402051
Submitted: 24 October 2022 | Revised: 29 December 2022 | Accepted: 10 January 2023 | Published: 6 February 2023
(This article belongs to the Section COVID-19 and the Cardiovascular System)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Atrial fibrillation (AF) is observed in arterial hypertension, heart failure, ischemic heart disease, and pulmonary pathology, particularly, chronic obstructive pulmonary disease (COPD). COPD in turn is a risk factor for developing these cardiovascular diseases and various arrhythmias. In the coronavirus disease (COVID) situation, such comorbid patients are the most vulnerable group with a high risk of adverse outcomes. The relevance of the relationship between COPD and coronavirus infection is explained by the similarity of clinical and pathophysiological manifestations, creating more difficulties in diagnosing and determining rational treatment. The aim of the current study is to explore the role COPD plays in the onset and progression of AF, especially in the situation of COVID-19. Methods: We searched PubMed databases and included studies with information on comorbid patients suffering from COPD and AF, as well as similar patients in the context of COVID-19. Results: A modern view on the problem of comorbidity of COPD and AF is presented. In the presence of cardiorespiratory comorbidity, symptoms of mutual worsening of the clinical course are observed, due to the commonality of some links of pathogenesis, including hypoxia, hemodynamic disturbances, activation of the sympathoadrenal system, systemic inflammation, and development of fibrosis, leading to myocardial remodeling, a decrease in the effectiveness of the therapy, and a worsening prognosis, especially in the context of COVID-19. Conclusions: The results of a study of the features of the pathogenesis and course of AF in COPD are presented, as well as the formation and progression of this comorbid pathology in the context of the COVID-19 pandemic.

Keywords
COVID-19
chronic obstructive pulmonary disease
atrial fibrillation
risk factors
myocardial remodeling
systemic inflammation
fibrosis
hypoxia
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