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新型冠状病毒肺炎的心血管表现

Cardiovascular Manifestations of COVID-19.

作者信息

Altamimi Hasan, Abid Abdul Rehman, Othman Fahmi, Patel Ashfaq

机构信息

Department of Cardiology and Cardiovascular Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

Heart Views. 2020 Jul-Sep;21(3):171-186. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_150_20. Epub 2020 Oct 13.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the cause of COVID-19, was first reported in Wuhan, China. SARS-CoV-2 especially involves alveolar epithelial cells, which results in respiratory symptoms more severe in patients with cardiovascular disease (CVD) probably linked with increased secretion of angiotensin-converting enzyme 2 in these patients compared with healthy individuals. Cardiac manifestations may contribute to overall mortality and even be the primary cause of death in many of these patients. A higher prevalence of hypertension (HTN) followed by diabetes mellitus and CVD was observed in COVID-19 patients. A higher case-fatality rate was seen among patients with pre-existing comorbid conditions, such as diabetes, chronic respiratory disease, HTN, and cancer, compared to a lesser rate in the entire population. Cardiovascular (CV) manifestations of COVID-19 encompass a wide spectrum, including myocardial injury, infarction, myocarditis-simulating ST-segment elevation myocardial infarction, nonischemic cardiomyopathy, coronary vasospasm, pericarditis, or stress (takotsubo) cardiomyopathy. This review is intended to summarize our current understanding of the CV manifestations of COVID-19 and also to study the relationship between SARS-CoV-2 and CVDs and discuss possible mechanisms of action behind SARS-CoV-2 infection-induced damage to the CV system.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是新冠肺炎的病原体,于中国武汉首次被报道。SARS-CoV-2尤其侵袭肺泡上皮细胞,这使得心血管疾病(CVD)患者的呼吸道症状更为严重,这可能与这些患者体内血管紧张素转换酶2的分泌量相较于健康个体增加有关。心脏表现可能会导致总体死亡率上升,甚至在许多此类患者中成为主要死因。新冠肺炎患者中观察到高血压(HTN)的患病率较高,其次是糖尿病和心血管疾病。与整个人口中较低的病死率相比,患有糖尿病、慢性呼吸道疾病、高血压和癌症等原有合并症的患者病死率更高。新冠肺炎的心血管(CV)表现涵盖范围广泛,包括心肌损伤、梗死、类似ST段抬高型心肌梗死的心肌炎、非缺血性心肌病、冠状动脉痉挛、心包炎或应激(应激性心肌病)性心肌病。这篇综述旨在总结我们目前对新冠肺炎心血管表现的认识,研究SARS-CoV-2与心血管疾病之间的关系,并探讨SARS-CoV-2感染导致心血管系统损伤背后可能的作用机制。

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