Cardiac complications associated with the influenza viruses A subtype H7N9 or pandemic H1N1 in critically ill patients under intensive care.
Cardiac complications associated with the influenza viruses A subtype H7N9 or pandemic H1N1 in critically ill patients under intensive care.
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DOI：
10.1016/j.bjid.2016.10.005
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发表时间：
2017-01
影响因子：
3.4
通讯作者：
Guo, Qiang
中科院分区：
文献类型：
--
作者：
Wang, Jiajia;Xu, Hua;Yang, Xinjing;Zhao, Daguo;Liu, Shenglan;Sun, Xue;Huang, Jian-an;Guo, Qiang
在最近的一份报告中，对甲型流感病毒亚型H7N9（H7N9）或2009年大流行性H1N1流感病毒住院患者的临床表现和病程进行了比较，但相关的心脏并发症仍不清楚。本回顾性研究调查了H7N9感染的危重患者的心脏并发症是否与感染大流行性H1N1流感病毒株的患者不同。疾病控制和预防中心通过逆转录聚合酶链反应分析确认了疑似病例，并具体确认了大流行性H1N1毒株。比较了中国苏州因H7N9（n = 24）或大流行性H1N1流感病毒（n = 22）感染住院的重症患者的个体水平数据。在重症监护室住院期间，心脏生化标志物、超声心动图和心电图的变化被认为是心脏并发症的体征。以下结果在H7N9组中相对于大流行性H1N1流感病毒组更常见：三尖瓣反流压差较大、窦性心动过速（心跳≥ 130 bpm）、ST段压低、右心室功能障碍和心脏生化标志物升高。心包积液在H1N1流感病毒患者中比H7N9组更常见。在两组中，大多数心脏并发症都是在流感症状出现后第6天至第14天发现的。那些发生心脏并发症的人在开始机械通气后的前四天特别脆弱。在绝大多数出院的H7N9患者中，心脏并发症是可逆的。重症住院H7N9患者的心脏并发症发生率高于2009年大流行H1N1流感病毒感染患者，心包积液除外。这项研究可能有助于预防，识别和治疗大流行性H1N1流感病毒和H7N9感染中流感引起的心脏并发症。
The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pandemic H1N1 influenza virus strain. Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention. Comparisons were conducted at the individual-level data of critically ill patients hospitalized with H7N9 (n = 24) or pandemic H1N1 influenza virus (n = 22) infections in Suzhou, China. Changes in cardiac biochemical markers, echocardiography, and electrocardiography during hospitalization in the intensive care unit were considered signs of cardiac complications. The following findings were more common among the H7N9 group relative to the pandemic H1N1 influenza virus group: greater tricuspid regurgitation pressure gradient, sinus tachycardia (heartbeat ≥ 130 bpm), ST segment depression, right ventricular dysfunction, and elevated cardiac biochemical markers. Pericardial effusion was more often found among pandemic H1N1 influenza virus patients than in the H7N9 group. In both groups, most of the cardiac complications were detected from day 6 to 14 after the onset of influenza symptoms. Those who developed cardiac complications were especially vulnerable during the first four days after initiation of mechanical ventilation. Cardiac complications were reversible in the vast majority of discharged H7N9 patients. Critically ill hospitalized H7N9 patients experienced a higher rate of cardiac complications than did patients with 2009 pandemic H1N1 influenza virus infections, with the exception of pericardial effusion. This study may help in the prevention, identification, and treatment of influenza-induced cardiac complications in both pandemic H1N1 influenza virus and H7N9 infections.
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影响因子：
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