Hothi Sandeep S, Jiang Jin, Steeds Richard P, Moody William E
Heart and Lung Centre, New Cross Hospital, Wolverhampton, United Kingdom.
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Front Cardiovasc Med. 2021 May 21;8:663864. doi: 10.3389/fcvm.2021.663864. eCollection 2021.
Coronavirus disease 2019 (COVID-19) was initially regarded as a disease of the lungs, which manifests as an acute respiratory illness and pneumonia, although more recently cardiac complications have been well-characterised. Serological cardiac biomarkers have been used to define acute myocardial injury, with significant elevation of high-sensitivity cardiac troponin (hs-cTn) associated with poor prognosis. Accordingly, 20-25% patients with acute myocardial injury (as defined by an elevated hs-cTn greater than the 99th percentile) have clinical signs of heart failure and increased mortality. An important outstanding clinical question is how best to determine the extent and nature of cardiac involvement in COVID-19. Non-invasive cardiac imaging has a well-established role in assessing cardiac structure and function in a wide range of cardiac diseases. It offers the potential to differentiate between direct and indirect COVID-19 effects upon the heart, providing incremental diagnostic and prognostic utility beyond the information yielded by elevated cardiac biomarkers in isolation. This review will focus on the non-invasive imaging assessment of cardiac involvement in COVID-19.
2019冠状病毒病（COVID-19）最初被认为是一种肺部疾病，表现为急性呼吸道疾病和肺炎，尽管最近心脏并发症已得到充分描述。血清学心脏生物标志物已被用于定义急性心肌损伤，高敏心肌肌钙蛋白（hs-cTn）显著升高与预后不良相关。因此，20%-25%的急性心肌损伤患者（定义为hs-cTn升高超过第99百分位数）有心力衰竭的临床体征且死亡率增加。一个重要的未解决临床问题是如何最好地确定COVID-19中心脏受累的程度和性质。非侵入性心脏成像在评估多种心脏疾病的心脏结构和功能方面具有确立的作用。它有可能区分COVID-19对心脏的直接和间接影响，除了单独的心脏生物标志物升高所提供的信息外，还能提供额外的诊断和预后效用。本综述将聚焦于COVID-19中心脏受累的非侵入性成像评估。
