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1.
Physiol Rev ; 102(1): 1-6, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1554572
2.
BMJ Case Rep ; 14(10)2021 Oct 19.
Article in English | MEDLINE | ID: covidwho-1501689

ABSTRACT

Previous reports have described non-ischaemic cardiomyopathy related to a variety of autoimmune diseases. However, very few case reports describe Sjögren disease as a contributing factor to cardiomyopathy. We report the case of a 69-year-old woman with a history of Sjögren disease who presented with cardiogenic shock. Laboratory testing and cardiac MRI revealing apical septal late gadolinium enhancement were consistent with an autoimmune aetiology. After ruling out ischaemic, infectious and other possible causes, the patient's clinical presentation was thought to be related to underlying Sjögren disease. She was treated with intravenous steroids and evidence-based heart failure therapy, but she eventually died after having declined heart transplantation. Given the rarity of Sjögren disease, no diagnostic criteria or standard treatment has been established for cardiomyopathy related to this disease. Diagnosis should be considered in patients who show evidence of autoimmune processes after other possible causes are ruled out.


Subject(s)
Cardiomyopathies , Sjogren's Syndrome , Aged , Cardiomyopathies/complications , Cardiomyopathies/diagnosis , Contrast Media , Female , Gadolinium , Humans , Shock, Cardiogenic/diagnosis , Shock, Cardiogenic/etiology , Sjogren's Syndrome/complications , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/drug therapy
3.
J Investig Med High Impact Case Rep ; 9: 23247096211024027, 2021.
Article in English | MEDLINE | ID: covidwho-1369483

ABSTRACT

Ventricular noncompaction is a rare, heterogeneous cardiomyopathy characterized by marked trabeculations and deep intertrabecular spaces with clinical sequelae of heart failure, arrhythmias, and cardioembolic events. In this article, we describe a patient with isolated right ventricular noncompaction who presented with submassive pulmonary embolism, which was managed with long-term direct oral anticoagulation.


Subject(s)
Cardiomyopathies , Heart Failure , Pulmonary Embolism , Cardiomyopathies/complications , Cardiomyopathies/diagnostic imaging , Heart Failure/etiology , Heart Ventricles/diagnostic imaging , Humans , Pulmonary Embolism/complications , Pulmonary Embolism/diagnostic imaging
4.
Dtsch Med Wochenschr ; 146(13-14): 911-914, 2021 Jul.
Article in German | MEDLINE | ID: covidwho-1307357

ABSTRACT

More than one year ago COVID-19 emerged to a rapidly expanding global pandemic. Along with a growing number of individuals infected with SARS-CoV-2, we gained substantial knowledge on development, progression and treatment of the disease. In the light of increasing worldwide infection rates during the current "third wave", we will give a short update on COVID-19 from a cardiological point-of-view.


Subject(s)
COVID-19 , Cardiology , Cardiomyopathies/complications , Thromboembolism/complications , COVID-19/complications , COVID-19/therapy , Cardiomyopathies/therapy , Humans , Thromboembolism/therapy
5.
J Cardiovasc Magn Reson ; 23(1): 68, 2021 06 10.
Article in English | MEDLINE | ID: covidwho-1262508

ABSTRACT

BACKGROUND: Early detection of myocardial involvement can be relevant in coronavirus disease 2019 (COVID-19) patients to timely target symptomatic treatment and decrease the occurrence of the cardiac sequelae of the infection. The aim of the present study was to assess the clinical value of cardiovascular magnetic resonance (CMR) in characterizing myocardial damage in active COVID-19 patients, through the correlation between qualitative and quantitative imaging biomarkers with clinical and laboratory evidence of myocardial injury. METHODS: In this retrospective observational cohort study, we enrolled 27 patients with diagnosis of active COVID-19 and suspected cardiac involvement, referred to our institution for CMR between March 2020 and January 2021. Clinical and laboratory characteristics, including high sensitivity troponin T (hs-cTnT), and CMR imaging data were obtained. Relationships between CMR parameters, clinical and laboratory findings were explored. Comparisons were made with age-, sex- and risk factor-matched control group of 27 individuals, including healthy controls and patients without other signs or history of myocardial disease, who underwent CMR examination between January 2020 and January 2021. RESULTS: The median (IQR) time interval between COVID-19 diagnosis and CMR examination was 20 (13.5-31.5) days. Hs-cTnT values were collected within 24 h prior to CMR and resulted abnormally increased in 18 patients (66.6%). A total of 20 cases (74%) presented tissue signal abnormalities, including increased myocardial native T1 (n = 11), myocardial T2 (n = 14) and extracellular volume fraction (ECV) (n = 10), late gadolinium enhancement (LGE) (n = 12) or pericardial enhancement (n = 2). A CMR diagnosis of myocarditis was established in 9 (33.3%), pericarditis in 2 (7.4%) and myocardial infarction with non-obstructive coronary arteries in 3 (11.11%) patients. T2 mapping values showed a moderate positive linear correlation with Hs-cTnT (r = 0.58; p = 0.002). A high degree positive linear correlation between ECV and Hs-cTnT was also found (r 0.77; p < 0.001). CONCLUSIONS: CMR allows in vivo recognition and characterization of myocardial damage in a cohort of selected COVID-19 individuals by means of a multiparametric scanning protocol including conventional imaging and T1-T2 mapping sequences. Abnormal T2 mapping was the most commonly abnormality observed in our cohort and positively correlated with hs-cTnT values, reflecting the predominant edematous changes characterizing the active phase of disease.


Subject(s)
COVID-19/complications , Cardiomyopathies/complications , Cardiomyopathies/diagnostic imaging , Magnetic Resonance Imaging/methods , Adult , Age Factors , Cohort Studies , Heart/diagnostic imaging , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sex Factors
6.
Viruses ; 13(6)2021 05 28.
Article in English | MEDLINE | ID: covidwho-1256664

ABSTRACT

Patients with underlying cardiovascular conditions are particularly vulnerable to severe COVID-19. In this project, we aimed to characterize similarities in dysregulated immune pathways between COVID-19 patients and patients with cardiomyopathy, venous thromboembolism (VTE), or coronary artery disease (CAD). We hypothesized that these similarly dysregulated pathways may be critical to how cardiovascular diseases (CVDs) exacerbate COVID-19. To evaluate immune dysregulation in different diseases, we used four separate datasets, including RNA-sequencing data from human left ventricular cardiac muscle samples of patients with dilated or ischemic cardiomyopathy and healthy controls; RNA-sequencing data of whole blood samples from patients with single or recurrent event VTE and healthy controls; RNA-sequencing data of human peripheral blood mononuclear cells (PBMCs) from patients with and without obstructive CAD; and RNA-sequencing data of platelets from COVID-19 subjects and healthy controls. We found similar immune dysregulation profiles between patients with CVDs and COVID-19 patients. Interestingly, cardiomyopathy patients display the most similar immune landscape to COVID-19 patients. Additionally, COVID-19 patients experience greater upregulation of cytokine- and inflammasome-related genes than patients with CVDs. In all, patients with CVDs have a significant overlap of cytokine- and inflammasome-related gene expression profiles with that of COVID-19 patients, possibly explaining their greater vulnerability to severe COVID-19.


Subject(s)
COVID-19/immunology , COVID-19/physiopathology , Cardiomyopathies/immunology , Coronary Artery Disease/immunology , Venous Thromboembolism/immunology , COVID-19/complications , COVID-19/genetics , Cardiomyopathies/complications , Cardiomyopathies/genetics , Coronary Artery Disease/complications , Coronary Artery Disease/genetics , Cytokines/genetics , Datasets as Topic , Humans , Immunocompromised Host/genetics , Inflammasomes/genetics , Lymphocyte Count , Patient Acuity , RNA-Seq , Venous Thromboembolism/complications
7.
Medicina (Kaunas) ; 57(4)2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1241288

ABSTRACT

The prediction and prevention of sudden cardiac death is the philosopher's stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competitive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.


Subject(s)
Cardiology , Cardiomyopathies , Cardiovascular Diseases , Channelopathies , Sports , Cardiomyopathies/complications , Channelopathies/complications , Channelopathies/genetics , Humans
10.
Breast J ; 27(4): 384-386, 2021 04.
Article in English | MEDLINE | ID: covidwho-1060031

ABSTRACT

Malignancy has historically prohibited solid organ transplant; however, patients with effectively treated, favorable-risk cancers should not necessarily be eliminated as transplant candidates. These cases require careful review by a multidisciplinary team. Here, we report the case of a woman with end-stage heart failure undergoing heart transplant evaluation during the COVID pandemic who was found to have early-stage, hormone receptor-positive breast cancer. Given her favorable cancer-related prognosis, a multidisciplinary committee recommended lumpectomy, accelerated partial breast irradiation, and adjuvant aromatase inhibitor therapy for definitive treatment to allow for consideration of orthotopic heart transplant.


Subject(s)
Breast Neoplasms/complications , COVID-19/complications , Cardiomyopathies/complications , Heart Failure/complications , Breast Neoplasms/surgery , Female , Heart Transplantation , Humans , Middle Aged , Pandemics
12.
Ann Palliat Med ; 9(6): 4156-4165, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-961974

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is a once-in-century crisis to public health. Although the pathogen for COVID-19, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been identified, the pandemic is still ongoing. The critically ill COVID-19 patients account for most disease-associated death; thus, there is an urgent need to identify prognostic factors that would help determine therapeutic approaches. METHODS: In this study, we retrospectively analyzed the clinical and laboratory findings in 100 critically ill COVID-19 patients in Hubei Women & Children Healthcare Hospital (Guanggu District), of whom 22 patients died in hospital, and 78 patients survived. RESULTS: We found that age, lymphocyte count, and total bilirubin concentration were an independent prognostic factor for critically ill COVID-19 patients. Of particular importance, we observed a significant elevation of myocardium injury biomarkers, including CK-MB, high-sensitivity cardiac troponini I (hs-cTnI), and Mb, in the non-survivor group. These myocardium injury biomarkers appeared to correlate with the time of survival, and two multivariate models have suggested hs-cTnI was a novel prognostic factor with a sensitivity of 75.0% and a specificity of 84.9%. CONCLUSIONS: Altogether, our study highlighted the prognostic significance of myocardium injury biomarkers in critically ill COVID-19 patients. Monitoring myocardium injury biomarkers would predict patient survival and guide therapeutic strategy.


Subject(s)
COVID-19/pathology , Cardiomyopathies/metabolism , Critical Illness , Aged , Aged, 80 and over , Biomarkers/metabolism , COVID-19/epidemiology , COVID-19/metabolism , COVID-19/virology , Cardiomyopathies/complications , China/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Prognosis , Retrospective Studies , SARS-CoV-2/isolation & purification
14.
Life Sci ; 262: 118496, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-797967

ABSTRACT

The infection epidemic event of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was formally declared a pandemic by World Health Organization on March 11th, 2020. Corona Virus Disease 2019 (COVID-19) is caused by SARS-CoV-2, a new type of coronavirus, which has high contagion and mainly causes respiratory symptoms. With the increase in confirmed cases, however, the infection symptoms turn to be diverse with secondary or first clinical symptoms relating to damage of the cardiovascular system and changes of myocardial enzyme spectrum, cardiac troponin I, electrocardiogram, cardiac function. The occurrence of extra-pulmonary manifestations, including immediately and long-term damage, means that the overall health burden caused by SARS-CoV-2 infection may be under-estimated because COVID-19 patients developed cardiovascular system injury are more likely to become serious. The factors such as directly pathogen-mediated damage to cardiomyocytes, down-regulated angiotensin-converting enzyme 2 (ACE2) expression, excessive inflammatory response, hypoxia and adverse drug reaction, are closely related to the occurrence and development of the course of COVID-19. In combination with recently published medical data of patients having SARS-CoV-2 infection and the latest studies, the manifestations of damage to cardiovascular system by COVID-19, possible pathogenic mechanisms and advances of the treatment are proposed in this article.


Subject(s)
COVID-19/complications , COVID-19/drug therapy , Cardiomyopathies/complications , Cardiomyopathies/drug therapy , SARS-CoV-2/drug effects , Angiotensin-Converting Enzyme 2/metabolism , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Down-Regulation/drug effects , Humans , Pandemics
15.
J Investig Med High Impact Case Rep ; 8: 2324709620947577, 2020.
Article in English | MEDLINE | ID: covidwho-695219

ABSTRACT

A 66-year-old male patient with coronavirus disease-19 (COVID-19) developed cardiogenic shock with echocardiographic evidence of decreased left ventricular ejection fraction and global hypokinesia concomitant with a robust systemic inflammatory response. Following the administration of convalescent plasma therapy and inotropic support, left ventricular function recovered fully in accordance with the decrease in the concentration of the inflammatory markers. Thus, we demonstrate the presence of transient reversible cardiomyopathy in a patient with severe COVID-19 and illustrate the association of acute cardiac dysfunction with profound systemic inflammation among COVID-19 patients.


Subject(s)
Betacoronavirus , Cardiomyopathies/therapy , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Aged , COVID-19 , Cardiomyopathies/complications , Cardiomyopathies/immunology , Coronavirus Infections/complications , Coronavirus Infections/immunology , Coronavirus Infections/metabolism , Humans , Immunization, Passive/methods , Male , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/immunology , SARS-CoV-2 , Stroke Volume , Treatment Outcome , Ventricular Function, Left
17.
Med Clin (Barc) ; 155(11): 488-490, 2020 12 11.
Article in English, Spanish | MEDLINE | ID: covidwho-613825

ABSTRACT

INTRODUCTION: There is controversy concerning the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II type-I receptor blockers (ARB) for treating hypertensive patients with Covid-19. It has been hypothesized that these drugs might increase the risk of severe Covid-19, but some authors suggested that blocking the renin-angiotensin system might actually decrease this risk. METHODS: Retrospective cohort study of all the consecutive hypertensive patients with confirmed SARS-CoV-2 infection in a health area. The outcome variable was hospitalization because of severe Covid-19. RESULTS: 539 subjects were diagnosed of SARS-CoV-2 infection. Of these, 157 (29.1%) had hypertension and were included in the study. Sixty-nine cases (43.9%) were hospitalized because of severe Covid-19. In multivariable analysis older age, diabetes and hypertensive myocadiopathy were related to a higher risk of hospital admission. ARB treatment was associated with a significantly lower risk of hospitalization (HR: 0.29, 95% CI: 0.10 - 0.88). A similar albeit not significant trend was observed for ACEI. CONCLUSION: ARB or ACEI treatment was not associated with a worse clinical outcome in consecutive hypertensive patients infected by SARS-CoV-2.


Subject(s)
Angiotensin II Type 1 Receptor Blockers/adverse effects , COVID-19/epidemiology , Hypertension/drug therapy , SARS-CoV-2 , Age Factors , Aged , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Cardiomyopathies/complications , Diabetes Complications , Female , Hospitalization , Humans , Male , Multivariate Analysis , Prognosis , Retrospective Studies
18.
Orphanet J Rare Dis ; 15(1): 157, 2020 06 22.
Article in English | MEDLINE | ID: covidwho-610299

ABSTRACT

Inherited heart disease represent a very heterogenous group of cardiac disorders, characterized by inherited, acquired, and often rare disorders affecting the heart muscle (cardiomyopathies) or the cardiac electrical system (ion channel disease). They are often familial diseases, and are among the leading cause of juvenile sudden death and heart failure. The aim of this paper is to give a perspective on how to run a clinical service during an epidemic or pandemic emergency and to describe the potential COVID-19 associated risks for patients affected by inherited heart diseases.


Subject(s)
Betacoronavirus , Cardiomyopathies/complications , Cardiomyopathies/genetics , Channelopathies/complications , Channelopathies/genetics , Coronavirus Infections/complications , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Genetic Predisposition to Disease , Humans , Outpatient Clinics, Hospital/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Rare Diseases/complications , Risk Factors , SARS-CoV-2 , Telemedicine/organization & administration
19.
J Am Soc Echocardiogr ; 33(6): 676-682, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-380547

ABSTRACT

BACKGROUND: Three cases of the application of focused cardiac ultrasound in patients with coronavirus disease 2019 are presented. METHODS: Cardiac point-of-care ultrasound, limited transthoracic echocardiography, and critical care echocardiography were applied in cases of heart failure, pulmonary embolism, and myocarditis with thrombus respectively. RESULTS: The impact on patient management and the global context of each presentation are discussed. CONCLUSIONS: Focused cardiac point-of-care ultrasound played an important, front-line role in the bedside management of patients during the COVID-19 pandemic in Wuhan, China.


Subject(s)
Betacoronavirus , Cardiomyopathies/diagnosis , Coronavirus Infections/epidemiology , Critical Care/methods , Echocardiography/methods , Pneumonia, Viral/epidemiology , Point-of-Care Systems , Pulmonary Embolism/diagnosis , Aged , COVID-19 , Cardiomyopathies/complications , China/epidemiology , Coronavirus Infections/complications , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pulmonary Embolism/complications , SARS-CoV-2
20.
Am Heart J ; 226: 24-25, 2020 08.
Article in English | MEDLINE | ID: covidwho-276507

ABSTRACT

Using Mt. Sinai (New York City) EMR health system data, we retrospectively analyzed a cohort of 8438 COVID-19 patients seen between March 1 and April 22, 2020. Risk of intubation and of death rose as a function of increasing age and as a function of greater cardiovascular comorbidity. Combining age and specific comorbidity markers showed patterns suggesting that cardiovascular comorbidities increased relative risks for adverse outcomes most substantially in the younger subjects with progressively diminishing relative effects at older ages.


Subject(s)
Betacoronavirus , Cardiovascular Diseases/epidemiology , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Respiration, Artificial/statistics & numerical data , Age Factors , Aged , COVID-19 , Cardiomyopathies/complications , Cardiomyopathies/epidemiology , Cardiomyopathies/mortality , Cardiovascular Diseases/blood , Cardiovascular Diseases/mortality , Comorbidity , Coronary Artery Disease/epidemiology , Coronary Artery Disease/mortality , Coronavirus Infections/blood , Coronavirus Infections/mortality , Electronic Health Records/statistics & numerical data , Female , Heart Failure/epidemiology , Heart Failure/mortality , Humans , Male , Middle Aged , New York City/epidemiology , Pandemics , Peripheral Arterial Disease/epidemiology , Peripheral Arterial Disease/mortality , Pneumonia, Viral/blood , Pneumonia, Viral/mortality , Respiration, Artificial/mortality , Retrospective Studies , Risk , SARS-CoV-2 , Troponin I/blood
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