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COVID-19 心肌炎与潜在心力衰竭负担。

COVID-19 myocarditis and prospective heart failure burden.

机构信息

Department of Hospital Therapy №1, I.M. Sechenov First Moscow State Medical University (Sechenov University) , Moscow, Russian Federation.

Institute for Experimental and Translational Cardiovascular Imaging, Goethe University Hospital Frankfurt , Frankfurt, Germany.

出版信息

Expert Rev Cardiovasc Ther. 2021 Jan;19(1):5-14. doi: 10.1080/14779072.2021.1844005. Epub 2020 Nov 27.

Abstract

: COVID-19 is causing considerable morbidity and mortality worldwide. Serious respiratory complications aside, the heart is also frequently involved. The mechanisms and the extent of the myocardial injury, along with the short and long-term cardiovascular (CV) outcomes in COVID-19 survivors remain unclear. : myocardial injury has been found in a considerable proportion of hospitalized COVID-19 patients and is associated with a worse prognosis. The late onset of CV complications with myocarditis-like changes revealed by CMR has been reported in COVID-19 survivors. Previous observational studies on viral myocarditis provide evidence of a significant incomplete recovery with residual dysfunction and remodeling of left ventricle. Incomplete recovery is thought to be the result of persistent myocardial inflammation due to a post-viral autoimmune response. Considering the significant inflammatory nature of COVID-19, COVID-19 survivors may be at risk of developing persistent residual myocardial injury, the sequelae of which are unclear. : COVID-19 is an emerging threat for the heart. The extent of CV injury, along with the short and long-term sequelae, requires further investigation. The early detection of residual myocardial changes in COVID-19 survivors is of utmost importance in order to identify those patients at risk of CV complication development.

摘要

新型冠状病毒肺炎(COVID-19)在全球范围内导致了大量的发病率和死亡率。除了严重的呼吸道并发症外,心脏也经常受到影响。COVID-19 幸存者的心肌损伤机制和程度,以及短期和长期心血管(CV)结局仍不清楚。

在住院的 COVID-19 患者中发现了相当一部分心肌损伤,并且与预后较差有关。CMR 显示 COVID-19 幸存者迟发性 CV 并发症伴心肌炎样改变已被报道。先前关于病毒性心肌炎的观察性研究提供了证据,表明左心室功能和重塑存在明显的不完全恢复。不完全恢复被认为是由于持续性病毒后自身免疫反应引起的持续性心肌炎症的结果。鉴于 COVID-19 的显著炎症性质,COVID-19 幸存者可能有发生持续性残余心肌损伤的风险,其后果尚不清楚。

COVID-19 对心脏构成新的威胁。CV 损伤的程度以及短期和长期的后遗症需要进一步研究。早期发现 COVID-19 幸存者的残余心肌变化对于识别那些有 CV 并发症发展风险的患者至关重要。

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