The aim: To evaluate the structural changes of the brain in relation to the formation of cognitive disorders (CD) in patients with arrhythmias

Materialsand methods: 147 patients with different clinical forms arrhythmias against the background of ischemic heart disease were examine. At the first stage, all patients with arrhythmias assessed cognitive functions. At the second stage, patients were distributed divided into two groups: the main group patients with CD, control – patients without CD. These groups underwent computed tomography examination of the brain.

Results:CD were established in 83% patients with arrhythmias. Mild CD were more often diagnosed in patients with persistent form of atrial fibrillation (AF), severe CD – in patients with permanent form of AF and atrioventricular blockade ІI-III degrees. Neuroimaging changes were found in 73.8% patients with CD and in 36% patients without CD. They were manifested by atrophic changes of the cortex, internal hydrocephalus, a decrease in the density of the brain sub- stance of the periventricular area. In patients with CD, compared to patients without CD, showed lacunar foci with predominant localization in the parietal and frontal lobes of the brain, periventricular and subcortical leukoaraiosis. Multiple correlations were established between CD and structural changes of the brain.

Conclusions: The increase in the severity of CD in patients with arrhythmias is associated with atrophic changes at the cortical-subcortical level, accompanied by the phenomena of internal hydrocephalus, periventricular and subcortical LA, lacunar foci, with a predominant localization in the frontal-temporal-occipital lobes, in the visual hump and basal ganglia of both cerebral hemispheres.

Вірус SARS-CoV-2 має тропність до ендотеліоцитів, що зумовлює різноманітні клінічні прояви. Системне запалення ендотелію призводить до зсідання крові в судинах. У літературі описано близько сотні випадків системних васкулітів як проявів COVID-19, що проявлялись ішемічно-некротичними змінами в кінцівках/пальцях, нервовій системі, кишках, сітківці ока, висипаннями на шкірі, а також інфарктами міокарда та інфарктами/інсультами мозку. Найбільш частим судинним проявом COVID-19 є синдром, подібний до хвороби Кавасакі (Kavasaki-like syndrome). Це ілюструється клінічним випадком.

The SARS-CoV-2 virus has a tropism for endotheliocytes, and it causes various clinical manifestations. Systemic inflammation of the endothelium leads to blood clotting in the vessels. In the literature, about a hundred cases of systemic vasculitis are described as manifestations of COVID-19. These cases were manifested by ischemic and necrotic changes in the limbs/fingers, nervous system, intestines, and retina, skin rashes, as well as myocardial infarctions and brain infarctions/strokes. The most frequent vascular manifestation of COVID-19 is Kawasaki-like syndrome. It is illustrated here by a clinical case.