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新型冠状病毒肺炎患者应激性心肌病的特征:系统综述。

Characteristics of Takotsubo cardiomyopathy in patients with COVID-19: Systematic scoping review.

作者信息

Techasatian Witina, Nishimura Yoshito, Nagamine Todd, Ha Gavin, Huang Ricky, Shah Parthav, Yeo Jihun, Kanitsoraphan Chanavuth

机构信息

Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, USA.

出版信息

Am Heart J Plus. 2022 Jan;13:100092. doi: 10.1016/j.ahjo.2022.100092. Epub 2022 Jan 31.

Abstract

BACKGROUND

COVID-19 has recently been associated with the development of Takotsubo cardiomyopathy (TCM). This scoping review aims to summarize the existing evidence regarding TCM in COVID-19 and offer future direction for study.

METHODS

Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer-reviewed articles with relevant keywords including "Takotsubo", "Stress-induced cardiomyopathy" and "COVID-19" from their inception to September 25, 2021.

RESULTS

A total of 40 articles with 52 cases were included. Patients with TCM and COVID-19 showed only slight female predominance (59.6%), median age of 68.5 years, and were mostly of the apical subtype (88.6%). All-cause mortality was 36.5%. The median LVEF was 30%. Compared to those without TCM, those with TCM in COVID-19 had more critical illness, higher mortality, lower LVEF, and higher cardiac and inflammatory biomarkers. Notably, the diagnostic criteria of TCM were considerably different between case reports and observational studies.

CONCLUSION

This scoping review identifies that TCM in COVID-19 may have distinct features that distinguish this condition from TCM without COVID-19. Future studies are warranted to help describe risk factors, determine the utility of inflammatory biomarkers and serum catecholamine levels, and establish disease-specific diagnostic criteria.

摘要

背景

新型冠状病毒肺炎(COVID-19)最近被认为与应激性心肌病(TCM)的发生有关。本综述旨在总结关于COVID-19患者中TCM的现有证据,并为未来研究提供方向。

方法

按照系统综述扩展版的首选报告项目(PRISMA),检索MEDLINE和EMBASE数据库,查找从数据库建立至2021年9月25日期间所有使用相关关键词(包括“Takotsubo”、“应激性心肌病”和“COVID-19”)的同行评审文章。

结果

共纳入40篇文章,包含52例病例。患有TCM的COVID-19患者中女性仅略占优势(59.6%),中位年龄为68.5岁,且大多为心尖部亚型(88.6%)。全因死亡率为36.5%。左心室射血分数(LVEF)中位数为30%。与未患TCM的患者相比,COVID-19合并TCM的患者病情更严重,死亡率更高,LVEF更低,心脏和炎症生物标志物水平更高。值得注意的是,病例报告和观察性研究中TCM的诊断标准存在很大差异。

结论

本综述发现,COVID-19患者中的TCM可能具有一些独特特征,使其有别于非COVID-19患者的TCM。未来有必要开展研究以帮助描述危险因素、确定炎症生物标志物和血清儿茶酚胺水平的效用,并建立针对该疾病的诊断标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e091/10978198/aebf2108caad/gr1.jpg

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