Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.
Biomed J. 2021 Apr;44(2):183-189. doi: 10.1016/j.bj.2020.06.001. Epub 2020 Jun 10.
The association between acute infections and cardiac injury, including myocarditis and acute myocardial infarction, is now well established. We have performed a systematic literature review for analyzing the results of epidemiological studies that measured cardiac troponins (cTn) in patients with Influenza virus infections. Overall, 14 articles were finally identified and analyzed. Taken together, the results of the scientific literature suggest that cTn elevation is a relatively rare phenomenon in patients with Influenza virus infection, with frequency generally comprised between 0 and 33%, more likely in elderly patients with significant comorbidities. In patients with modest cTn elevations, this phenomenon is apparently self-limited, transient and reversible, and especially involves patients with Influenza A (especially H1N1). In the minority of patients exhibiting an abrupt appearance of cardiovascular symptoms and concomitant elevation of cTn values, the relative increase of this biomarker reflects the presence of an underlying cardiac injury, that can be either myocarditis or an acute ischemic episode. Enhanced cTn values can also be more frequently observed in Influenza patients with complicated disease, in those developing acute respiratory distress syndrome and cardiac dysfunction, as well as in those at higher risk of death. cTn measurement shall be considered a valuable option in all patients developing acute cardiovascular symptoms during Influenza virus infections, as well as in those bearing cardiac or extra-cardiac comorbidities who bear a higher risk of complications.
急性感染与心脏损伤（包括心肌炎和急性心肌梗死）之间的关联现已得到充分证实。我们进行了系统的文献回顾，分析了测量流感病毒感染患者心脏肌钙蛋白（cTn）的流行病学研究结果。最终共确定并分析了 14 篇文章。总之，科学文献的结果表明，cTn 升高在流感病毒感染患者中是一种相对罕见的现象，其发生率通常在 0%至 33%之间，在有显著合并症的老年患者中更常见。在 cTn 适度升高的患者中，这种现象显然是自限性、短暂和可逆的，特别是涉及到甲型流感（尤其是 H1N1）患者。在少数出现心血管症状和 cTn 值同时升高的患者中，该生物标志物的相对增加反映了潜在的心脏损伤，可能是心肌炎或急性缺血事件。在病情复杂、发生急性呼吸窘迫综合征和心功能障碍的流感患者以及死亡风险较高的患者中，cTn 值升高更为常见。在流感病毒感染期间出现急性心血管症状的所有患者中，以及在存在更高并发症风险的心脏或心脏外合并症的患者中，cTn 测量都应被视为一种有价值的选择。
