COVID-19における心臓損傷の主な原因として微小血栓:病理学的研究
Dario Pellegrini1, Rika Kawakami2, Giulio Guagliumi1
1Ospedale Papa Giovanni XXIII, Bergamo, Italy (D.P., G.G., A.G., A.N., L.F., I.P., M.B.).
Circulation
|January 22, 2021
まとめ
冠動脈疾患ではなくマイクロトロンビは,COVID-19患者の心臓損傷と筋細胞死滅の主な原因でした. これらのマイクロトロンビは,フィブリンとコンプリメントが豊富で,特化した抗トロンブティック戦略がSARS-CoV-2感染による心臓損傷を軽減するのに役立つことを示唆しています.
科学分野:
- 心臓病科
- 病理学について
- 感染症
背景:
- 心臓の損傷は,COVID-19の頻繁な合併症であり,より悪い予後と関連しています.
- SARS-CoV-2による心筋損傷の正確なメカニズムと性質は不明である.
研究 の 目的:
- COVID-19で死亡した患者の心臓損傷の病理的メカニズムを調査する.
- SARS-CoV-2 感染症の背景における筋細胞死滅の根本的な原因を特定する.
主な方法:
- COVID-19で死亡した40人の心臓の体系的な病理学的分析.
- 心臓の分類は,急性筋細胞死滅の有無に基づいています.
- COVID-19症例と対照群における心臓微小血栓組成の比較分析.
主要な成果:
- 主に左心室で,ミオサイト死滅は35%の症例で観察された.
- 心筋の毛細血管と小動脈の微小血栓は,死滅の主要な原因で,死滅の症例の64. 3%で発見されました.
- COVID-19に関連した微小血栓は,他の血栓型と比較して,フィブリンとC5b-9の堆積量が増加した.
結論:
- 微小血栓は,COVID-19における筋細胞死滅の主な病理的要因である.
- これらの微小血栓の組成は,他の血栓性イベントと有意に異なる.
- COVID-19の心臓合併症の管理には,特定の抗血栓治療の開発が不可欠です.
関連する概念動画
Myocarditis I: Introduction
162
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
162
Venous Thrombosis I: Introduction
121
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
121
Coronary Artery Disease II: Pathophysiology
186
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
186
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
555
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
555
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
135
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
135
Anticoagulant Drugs: Low-Molecular-Weight Heparins
1.3K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.3K


