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先进成像技术在新冠病毒病心血管并发症中的作用

Role of advanced imaging in COVID-19 cardiovascular complications.

作者信息

Catapano Federica, Marchitelli Livia, Cundari Giulia, Cilia Francesco, Mancuso Giuseppe, Pambianchi Giacomo, Galea Nicola, Ricci Paolo, Catalano Carlo, Francone Marco

机构信息

Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.

Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.

出版信息

Insights Imaging. 2021 Feb 24;12(1):28. doi: 10.1186/s13244-021-00973-z.

Abstract

Clinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.

摘要

新冠肺炎患者的临床表现以呼吸道症状为主,但心脏并发症较为常见,且与发病率和死亡率增加相关。心脏损伤的潜在病理机制仍未完全阐明,可能取决于直接病毒损伤与不受控制的免疫激活的综合作用。这些患者的心脏受累范围从轻微心肌损伤到心源性休克。先进的心脏成像在鉴别广泛的鉴别诊断中起着关键作用。本文旨在综述先进的多模态成像在疑似SARS-CoV-2相关心血管受累患者中的价值及其在风险分层和个性化治疗策略中的重要作用。基于我们的经验,我们还试图提出可能的诊断算法,以便合理利用心脏CT和CMR等先进成像工具,避免不必要的检查和诊断延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d40b/7904993/504fdfa45588/13244_2021_973_Fig1_HTML.jpg

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