由于COVID-19引起的心脏干扰:图像和组织病理学的见解
Valentina O Puntmann1, Anastasia Shchendrygina1, Carlos Rodriguez Bolanos1
1Institute for Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Frankfurt Frankfurt am Main, Germany.
European cardiology
|November 9, 2023
概括
COVID-19 (PASC) 后急性心血管后续导致持续的心脏问题,影响了先前心脏病患者和以前健康的人. 识别和诊断这些复杂的心血管综合征对于患者的治疗结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 感染可能导致持续的心脏症状,称为急性心血管后续 (PASC).
- 在COVID-19中,急性心脏损伤与细胞因子释放,缺血和血栓形成有关,特别影响了先前患有心脏病的患者.
- 来自直接病毒感染的心肌炎不常见;慢性PASC包括现有的心血管疾病的恶化或明显的炎症综合征.
研究的目的:
- 突出了SARS-CoV-2感染后急性心血管后续 (PASC) 的越来越多的认可.
- 为了区分PASC表现:以前存在的心血管疾病的恶化与由免疫失调驱动的新心血管综合征.
- 强调PASC临床识别和管理方面的挑战,以及改善诊断工具的需要.
主要方法:
- 审查目前对SARS-CoV-2感染后心脏并发症的理解.
- 分析导致急性心脏损伤和慢性PASC表现的机制.
- 讨论PASC的临床影响,诊断需求和管理挑战.
主要成果:
- 帕斯克包括两个主要的表型:先前存在的心血管疾病的恶化和与免疫失调相关的新型心血管综合征.
- 这两种PASC呈现都与心血管风险升高,长期残疾和生活质量下降有关.
- 后一种PASC表型影响了大量以前健康的个体.
结论:
- 有效的临床识别和PASC的管理仍然是一个重大挑战.
- 需要敏感的诊断方法来识别PASC心血管综合征中微妙的炎症变化.
- 加强管理炎症性心脏病的临床专业知识对于解决PASC至关重要.
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