Coronavirus and Cardiovascular Disease, Myocardial Injury, and Arrhythmia: JACC Focus Seminar.
Coronavirus and Cardiovascular Disease, Myocardial Injury, and Arrhythmia: JACC Focus Seminar.
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DOI：
10.1016/j.jacc.2020.08.059
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发表时间：
2020-10-27
影响因子：
24
通讯作者：
Fuster V
中科院分区：
文献类型：
--
作者：
Giustino G;Pinney SP;Lala A;Reddy VY;Johnston-Cox HA;Mechanick JI;Halperin JL;Fuster V
严重急性呼吸综合征冠状病毒 2 感染广泛影响心血管系统。在2019冠状病毒病的背景下，直接的病毒感染和炎症、内皮激活和微血管血栓形成造成的间接损伤都会发生。决定心血管损伤程度的是病毒接种量、宿主免疫反应的强度和合并症的存在。大约四分之一的住院患者发生心肌损伤，这与机械呼吸机支持的更大需求和更高的医院死亡率相关。心血管损伤的核心病理生理学是病毒与血管紧张素转换酶 2 受体结合之间的相互作用，以及这种作用对肾素-血管紧张素系统、人体先天免疫反应以及对细胞因子产生的血管反应的影响。本综述的目的是描述心血管损伤的机制，包括血栓栓塞性疾病和心律失常的机制，并讨论其临床后遗症。严重急性呼吸综合征冠状病毒 2 感染 (COVID-19) 以多种方式影响心血管系统。约 25% 的 COVID-19 住院患者可检测到心肌损伤，并且与死亡风险增加相关。所描述的 COVID-19 患者心肌损伤机制包括氧供需失衡、病毒直接侵袭心肌、炎症、急性心肌梗死冠状动脉斑块破裂、微血管血栓形成和肾上腺素能应激。
The cardiovascular system is affected broadly by severe acute respiratory syndrome coronavirus 2 infection. Both direct viral infection and indirect injury resulting from inflammation, endothelial activation, and microvascular thrombosis occur in the context of coronavirus disease 2019. What determines the extent of cardiovascular injury is the amount of viral inoculum, the magnitude of the host immune response, and the presence of co-morbidities. Myocardial injury occurs in approximately one-quarter of hospitalized patients and is associated with a greater need for mechanical ventilator support and higher hospital mortality. The central pathophysiology underlying cardiovascular injury is the interplay between virus binding to the angiotensin-converting enzyme 2 receptor and the impact this action has on the renin-angiotensin system, the body’s innate immune response, and the vascular response to cytokine production. The purpose of this review was to describe the mechanisms underlying cardiovascular injury, including that of thromboembolic disease and arrhythmia, and to discuss their clinical sequelae. The cardiovascular system is affected in diverse ways by severe acute respiratory syndrome coronavirus 2 infection (COVID-19). Myocardial injury can be detected in ∼25% of hospitalized patients with COVID-19 and is associated with an increased risk of mortality. Described mechanisms of myocardial injury in patients with COVID-19 include oxygen supply–demand imbalance, direct viral myocardial invasion, inflammation, coronary plaque rupture with acute myocardial infarction, microvascular thrombosis, and adrenergic stress.
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影响因子：
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发表时间：
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影响因子：
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