Department of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA.
Department of Cardiology, Baylor College of Medicine, 2002 Holcombe Blvd, Houston, TX, 77030, USA.
Curr Heart Fail Rep. 2024 Oct;21(5):485-497. doi: 10.1007/s11897-024-00677-7. Epub 2024 Jul 23.
This review examines the pathophysiological interactions between COVID-19 and heart failure, highlighting the exacerbation of heart failure in COVID-19 patients. It focuses on the complex mechanisms driving worse outcomes in these patients.
Patients with pre-existing heart failure experience more severe symptoms and higher mortality rates due to mechanisms such as cytokine storms, myocardial infarction, myocarditis, microvascular dysfunction, thrombosis, and stress cardiomyopathy. Elevated biomarkers like troponin and natriuretic peptides correlate with severe disease. Long-term cardiovascular risks for COVID-19 survivors include increased incidence of heart failure, non-ischemic cardiomyopathy, cardiac arrest, and cardiogenic shock. COVID-19 significantly impacts patients with pre-existing heart failure, leading to severe symptoms and higher mortality. Elevated cardiac biomarkers are indicators of severe disease. Acute and long-term cardiovascular complications are common, calling for ongoing research into targeted therapies and improved management strategies to better prevent, diagnose, and treat heart failure in the context of COVID-19.
本文回顾了 COVID-19 与心力衰竭之间的病理生理相互作用，强调了 COVID-19 患者心力衰竭的恶化。重点讨论了导致这些患者预后更差的复杂机制。
由于细胞因子风暴、心肌梗死、心肌炎、微血管功能障碍、血栓形成和应激性心肌病等机制，患有心力衰竭的患者出现更严重的症状和更高的死亡率。升高的生物标志物，如肌钙蛋白和利钠肽，与严重疾病相关。COVID-19 幸存者的长期心血管风险包括心力衰竭、非缺血性心肌病、心搏骤停和心源性休克发生率增加。COVID-19 对患有心力衰竭的患者影响显著，导致严重症状和更高的死亡率。升高的心脏生物标志物是疾病严重程度的指标。急性和长期心血管并发症很常见，因此需要进行针对心力衰竭的靶向治疗和改进管理策略的研究，以更好地预防、诊断和治疗 COVID-19 背景下的心力衰竭。
