在COVID-19之后的心肌缺血:心血管磁共振研究
J Ranjit Arnold1, Jian L Yeo2, Charley A Budgeon2,3
1University of Leicester and The NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK. jra14@le.ac.uk.
The international journal of cardiovascular imaging
|December 31, 2024
概括
心肌缺血发生在大约20%的COVID-19患者中,肌素水平升高,类似于对照组. 这表明冠状动脉问题不是COVID-19相关心脏损伤的主要原因.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗成像医学成像
背景情况:
- 在COVID-19患者中心肌损伤的确切原因尚未完全理解.
- 心血管磁共振 (CMR) 是评估心脏健康的关键成像技术.
- 在COVID-19患者中心脏托罗邦素水平升高表明潜在的心脏损伤.
研究的目的:
- 为了确定COVID-19患者心肌缺血的频率,这些患者血红素水平升高.
- 调查这些患者心肌缺血和心肌损伤之间的关系.
- 探索COVID-19相关心肌损伤的潜在机制.
主要方法:
- 未来的,多中心的COVID-HEART研究.
- 多参数CMR包括心室体积,应力 perfusion 和T1/T2映射.
- 在59名COVID-19患者 (COVID+/troponin+) 和37名匹配的对照组 (COVID-/并发症+) 之间的比较.
主要成果:
- 诱导性心肌缺血发生在19%的COVID-19患者和22%的对照组中 (p=0.72).
- 在COVID-19患者中,缺血模式包括表心冠状动脉疾病 (8名患者) 和微血管疾病 (3名患者).
- 根据先前的心肌梗塞,再血管化或心肌痕,没有观察到缺血频率的显著差异.
结论:
- 大约20%的住院COVID-19患者患有肌痛性心脏缺血,肌痛性心脏缺血的发生率与对照组相似,肌痛性心脏缺血的发生率与对照组相似.
- 缺血和心肌痕之间缺乏关联表明冠状动脉异常不是COVID-19引起的心肌损伤的主要驱动因素.
- 需要进一步的研究来充分阐明COVID-19相关心肌损伤的病理生理学.
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