Cicco Sebastiano, Vacca Antonio, Cariddi Christel, Carella Rossella, Altamura Gianluca, Solimando Antonio Giovanni, Lauletta Gianfranco, Pappagallo Fabrizio, Cirulli Anna, Stragapede Assunta, Susca Nicola, Grasso Salvatore, Ria Roberto
Internal Medicine Unit "Guido Baccelli", Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari Aldo Moro, Azienda Ospedaliero-Universitaria Policlinico, Piazza G. Cesare 11, I-70124 Bari, Italy.
Division of Internal Medicine, Department of Medicine, Building 8, University of Udine, I-33100 Udine, Italy.
Diagnostics (Basel). 2021 Jul 15;11(7):1271. doi: 10.3390/diagnostics11071271.
Coronavirus Disease 2019 (COVID-19) has been a pandemic challenge for the last year. Cardiovascular disease is the most described comorbidity in COVID-19 patients, and it is related to the disease severity and progression. COVID-19 induces direct damage on cardiovascular system, leading to arrhythmias and myocarditis, and indirect damage due to endothelial dysfunction and systemic inflammation with a high inflammatory burden. Indirect damage leads to myocarditis, coagulation abnormalities and venous thromboembolism, Takotsubo cardiomyopathy, Kawasaki-like disease and multisystem inflammatory syndrome in children. Imaging can support the management, assessment and prognostic evaluation of these patients. Ultrasound is the most reliable and easy to use in emergency setting and in the ICU as a first approach. The focused approach is useful in management of these patients due its ability to obtain quick and focused results. This tool is useful to evaluate cardiovascular disease and its interplay with lungs. However, a detailed echocardiography evaluation is necessary in a complete assessment of cardiovascular involvement. Computerized tomography is highly sensitive, but it might not always be available. Cardiovascular magnetic resonance and nuclear imaging may be helpful to evaluate COVID-19-related myocardial injury, but further studies are needed. This review deals with different modalities of imaging evaluation in the management of cardiovascular non-ischaemic manifestations of COVID-19, comparing their use in emergency and in intensive care.
在过去一年里，2019冠状病毒病（COVID-19）一直是一项全球性挑战。心血管疾病是COVID-19患者中描述最多的合并症，它与疾病的严重程度和进展相关。COVID-19会对心血管系统造成直接损害，导致心律失常和心肌炎，还会因内皮功能障碍和具有高炎症负荷的全身炎症而造成间接损害。间接损害会导致心肌炎、凝血异常和静脉血栓栓塞、应激性心肌病、川崎病样疾病以及儿童多系统炎症综合征。影像学检查可为这些患者的管理、评估和预后评价提供支持。在急诊环境和重症监护病房中，超声作为首选方法是最可靠且易于使用的。聚焦超声检查方法因其能够快速获得聚焦结果，对这些患者的管理很有用。该工具对于评估心血管疾病及其与肺部的相互作用很有用。然而，在全面评估心血管受累情况时，需要进行详细的超声心动图检查。计算机断层扫描高度敏感，但可能并非随时可用。心血管磁共振成像和核成像可能有助于评估与COVID-19相关的心肌损伤，但仍需进一步研究。本综述探讨了在COVID-19心血管非缺血性表现管理中不同的影像学评估方式，并比较了它们在急诊和重症监护中的应用。
