AbdelMassih Antoine Fakhry, Ramzy David, Nathan Lauren, Aziz Silvia, Ashraf Mirette, Youssef Nourhan Hatem, Hafez Nouran, Saeed Rana, Agha Hala
Pediatric Cardiology Unit, Pediatrics' Department, Faculty of Medicine, Cairo University.
Pediatric Cardio-Oncology Department, Children Cancer Hospital of Egypt.
Cardiovasc Endocrinol Metab. 2020 Apr 20;9(3):121-124. doi: 10.1097/XCE.0000000000000207. eCollection 2020 Sep.
Coronavirus disease 2019 (COVID-19) has been declared a pandemic on 11 March 2020 by the WHO. Despite being mainly a respiratory virus, cardiac complications have been described. These range from sudden cardiac death to subtle diastolic dysfunction after recovery from COVID-19. The commonest cardiac presentation to date is acute heart failure resulting from biventricular or left ventricular hypokinesis and elevation of cardiac troponins. It has been shown that COVID-19 downregulates angiotensin-converting enzyme-2, which has protective effects on the endothelium and cardiomyocytes. It has also been proven that COVID-19 induces a state of hypercytokinaemia, some cytokines such as interleukin-1 and interleukin-6 have an injurious effect on the myocardium and endothelium, respectively. Such pathogenic mechanisms might play a crucial role in induction of cardiomyocyte injury and impaired myocardial perfusion probably through coronary endothelial dysfunction. The understanding and linking of such mechanisms might help in tailoring drug repurposing for treatment or prophylaxis of COVID-19 cardiovascular complications.
2020年3月11日，世界卫生组织宣布2019冠状病毒病（COVID-19）为大流行病。尽管它主要是一种呼吸道病毒，但已有心脏并发症的相关描述。这些并发症范围从心源性猝死到COVID-19康复后的轻微舒张功能障碍。迄今为止，最常见的心脏表现是双心室或左心室运动功能减退以及心肌肌钙蛋白升高导致的急性心力衰竭。研究表明，COVID-19会下调血管紧张素转换酶2，该酶对内皮细胞和心肌细胞具有保护作用。也已证实，COVID-19会引发高细胞因子血症状态，一些细胞因子，如白细胞介素-1和白细胞介素-6，分别对心肌和内皮细胞有损伤作用。这种致病机制可能在诱导心肌细胞损伤和心肌灌注受损中起关键作用，可能是通过冠状动脉内皮功能障碍。对这些机制的理解和关联可能有助于定制药物再利用方案，以治疗或预防COVID-19的心血管并发症。
