Moady Gassan, Atar Shaul
Department of Cardiology, Galilee Medical Center, Nahariya, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
CJC Open. 2021 May 26;3(10):1249-1256. doi: 10.1016/j.cjco.2021.05.011. eCollection 2021 Oct.
The current coronavirus disease 2019 (COVID-19) presents an ongoing medical challenge, as it involves multiple organs, including the cardiovascular system. Takotsubo syndrome (TTS) has been described in the context of COVID-19 in 2 different scenarios: as a direct complication of the infection, and as an indirect outcome secondary to the psychological burden of quarantine and social isolation (ie, stress-induced cardiomyopathy). Confirming the diagnosis of TTS in COVID-19 may be challenging due to the limited use of coronary angiography consistent with the recommended guidelines aimed at minimizing contact with infected individuals. The use of natriuretic peptide as a diagnostic and prognostic marker in this context may not be reliable as this peptide is already elevated in severe cases of COVID-19 regardless of TTS diagnosis. A relatively high incidence of complications has been reported in these cases, probably related to the severity of the underlying infectious disease. Although quarantine-induced stress cardiomyopathy is an unsurprising outcome of the powerful stress resulting from the current pandemic, conflicting results have been reported, and further studies are encouraged to determine the true incidence.
目前的2019冠状病毒病（COVID-19）带来了持续的医学挑战，因为它累及多个器官，包括心血管系统。在COVID-19背景下，已在2种不同情况下描述了应激性心肌病（TTS）：作为感染的直接并发症，以及作为隔离和社会隔离的心理负担（即应激性心肌病）导致的间接结果。由于与旨在尽量减少与感染者接触的推荐指南一致，冠状动脉造影的使用有限，因此在COVID-19中确诊TTS可能具有挑战性。在这种情况下，使用利钠肽作为诊断和预后标志物可能不可靠，因为无论是否诊断为TTS，在COVID-19重症病例中该肽已经升高。据报道，这些病例的并发症发生率相对较高，可能与潜在传染病的严重程度有关。尽管隔离引起的应激性心肌病是当前大流行导致的强大应激的一个不出意料的结果，但已有相互矛盾的报道，因此鼓励进一步研究以确定其真实发病率。
