Infusino Fabio, Cimino Sara, Lombardi Marco, Mancone Massimo, Cavarretta Elena, Frati Giacomo, Pugliese Francesco, Fedele Francesco, Biondi Zoccai Giuseppe
Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy -
Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy.
Minerva Cardioangiol. 2020 Aug;68(4):339-346. doi: 10.23736/S0026-4725.20.05271-8. Epub 2020 May 29.
In recent months SARS-CoV-2 has spread rapidly throughout the world. The case fatality rate is higher in cardiovascular disease and hypertension. Other comorbidities do not seem to confer the same risk, therefore the understanding of the relationship between infection and cardiovascular system could be a crucial point for the fight against the virus. A great interest is directed towards the angiotensin 2 converting enzyme (ACE 2) which is the SARS-CoV-2 receptor and creates important connections between the virus replication pathway, the cardiovascular system and blood pressure. All cardiovascular conditions share an imbalance of the renin angiotensin system in which ACE 2 plays a central role. In the early pandemic period, much confusion has appeared about the management of therapy with angiotensin converting enzyme inhibitors and angiotensin receptor blockers especially in infected patients and in those at risk of critical illness in case of infection. In this article we will try to reorder the major opinions currently emerging on this topic.
近几个月来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在全球迅速传播。心血管疾病和高血压患者的病死率更高。其他合并症似乎并未带来同样的风险，因此，了解感染与心血管系统之间的关系可能是抗击该病毒的关键所在。人们对血管紧张素2转换酶（ACE 2）极为关注，它是SARS-CoV-2的受体，在病毒复制途径、心血管系统和血压之间建立了重要联系。所有心血管疾病都存在肾素血管紧张素系统失衡的情况，而ACE 2在其中起着核心作用。在疫情早期，对于使用血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂进行治疗的管理出现了很多困惑，尤其是在感染患者以及在感染时处于危重症风险的患者中。在本文中，我们将尝试梳理目前在该主题上出现的主要观点。
