scholarly journals Role of advanced imaging in COVID-19 cardiovascular complications

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Federica Catapano ◽  
Livia Marchitelli ◽  
Giulia Cundari ◽  
Francesco Cilia ◽  
Giuseppe Mancuso ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Injury ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Advanced Imaging ◽  
Cardiovascular Involvement ◽  
Diagnostic Delays

AbstractClinical manifestations of COVID-19 patients are dominated by respiratory symptoms, but cardiac complications are commonly observed and associated with increased morbidity and mortality. Underlying pathological mechanisms of cardiac injury are still not entirely elucidated, likely depending on a combination of direct viral damage with an uncontrolled immune activation. Cardiac involvement in these patients ranges from a subtle myocardial injury to cardiogenic shock. Advanced cardiac imaging plays a key role in discriminating the broad spectrum of differential diagnoses. Present article aims to review the value of advanced multimodality imaging in patients with suspected SARS-CoV-2-related cardiovascular involvement and its essential role in risk stratification and tailored treatment strategies. Based on our experience, we also sought to suggest possible diagnostic algorithms for the rationale utilization of advanced imaging tools, such as cardiac CT and CMR, avoiding unnecessary examinations and diagnostic delays.

scholarly journals Acute Myocardial Infarction Due to Microvascular Obstruction in a Young Woman Who Recently Recovered from COVID-19 Infection

2021 ◽  
Vol 8 (6) ◽  
pp. 66
Author(s):  
Abukar Mohamed Ali ◽  
Daanyaal Wasim ◽  
Terje H. Larsen ◽  
Nigussie Bogale ◽  
Øyvind Bleie ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Young Woman ◽  
Multimodality Imaging ◽  
Cardiac Injury ◽  
Acute Chest Pain ◽  
Lateral Wall ◽  
Cardiovascular Complications ◽  
A Minor ◽  
At Home

Although cardiovascular complications are common in hospitalized COVID-19 patients, those with milder cases who recovered at home are less studied. Here, we report the case of a young woman who recently recovered from COVID-19 at home. A week after recovery, she was admitted to our institution with acute chest pain, signs of ischemia on the electrocardiogram and elevated cardiac troponins. Coronary angiography showed normal epicardial coronary arteries, but the cardiac magnetic resonance showed transmural late gadolinium enhancement (LGE) in the mid-ventricular level of the lateral wall. The findings were strongly suggestive of a minor transmural myocardial infarction. This case report highlights the role of multimodality imaging in detecting cardiac injury in COVID-19 patients as well as the fact that mild COVID-19 cases who recovered at home are also exposed to thromboembolic events during the convalescent period.

Review: SARS-CoV-2, Cardiovascular Disease, Pathophysiology and Role of ACE2 in Cardiac Injury

2021 ◽  
pp. 1-20
Keyword(s):  
Cardiovascular Disease ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Receptor Blockers ◽  
Cardiac Injury ◽  
Clinical Manifestations ◽  
Cardiac Complications ◽  
Converting Enzyme ◽  
Structural Protein ◽  
Coronary Syndrome

The coronavirus disease-2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has hit the world very hard by affecting millions of people across countries hence posing a major health threat on a global scale. This novel virus is thought to enter and cause infection in its host through the attachment of its structural protein known as the S-glycoprotein to angiotensin-converting enzyme 2 (ACE2). COVID-19 is presented with asymptomatic, mild, or severe pneumonia-like symptoms. During the infection, the cardiovascular system is affected by unknown pathophysiological processes. Among COVID-19 patients, cardiovascular disease (CVD) is resulting into cardiac injury, acute coronary syndrome (ACS), myocardial infarction (MI), arrhythmic infestation and myocarditis. The results of the meta-analysis suggest that CVD and its risk factors are closely related to fatal outcomes in COVID-19 for patients across all ages. Hence, from a cardiovascular standpoint, there are concerns as to whether patients with underlying cardiovascular conditions are at a higher risk of an aggravated COVID-19 infection. Also, as to whether COVID-19 infections induce cardiomyopathies that were not in existence prior to the infection. Nonetheless, much needs to be discovered about the cardiac involvement of this novel coronavirus (nCoV) infection and its relationship with cardiovascular diseases (CVDs). For acute CVD events, the use of antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin-receptor blockers (ARBs) and statins are recommended per practice guidelines. Whether the medications which patients used for cardiovascular disease will interfere with the treatment or the outcome of COVID-19, is still unknown. With the invent of vaccines and as new clinical evidences emerging, the diagnosis and treatment may change. The purpose of this concise review is to discuss CVD and related potential disorders in patients with COVID-19 which involves SARS-CoV-2 infection, pathophysiology, role of ACE2 in cardiac injury, possible mechanism of cardiac complications and clinical manifestations.

Omentin-1 attenuates glucocorticoid-induced cardiac injury by phosphorylating GSK3β

2021 ◽  
Vol 66 (4) ◽  
pp. 273-283
Author(s):  
Zhousheng Jin ◽  
Fangfang Xia ◽  
Jiaojiao Dong ◽  
Tingting Lin ◽  
Yaoyao Cai ◽  
...  
Keyword(s):  
Side Effects ◽  
Cardiac Hypertrophy ◽  
Cardiac Injury ◽  
Experimental Studies ◽  
Chronic Administration ◽  
Cardiovascular Complications ◽  
Rat Serum ◽  
Cardiac Side Effects ◽  
Beneficial Effects

Glucocorticoid excess often causes a variety of cardiovascular complications, including hypertension, atherosclerosis, and cardiac hypertrophy. To abrogate its cardiac side effects, it is necessary to fully disclose the pathophysiological role of glucocorticoid in cardiac remodelling. Previous clinical and experimental studies have found that omentin-1, one of the adipokines, has beneficial effects in cardiovascular diseases, and is closely associated with metabolic disorders. However, there is no evidence to address the potential role of omentin-1 in glucocorticoid excess-induced cardiac injuries. To uncover the links, the present study utilized rat model with glucocorticoid-induced cardiac injuries and clinical patients with abnormal cardiac function. Chronic administration of glucocorticoid excess reduced rat serum omentin-1 concentration, which closely correlated with cardiac functional parameters. Intravenous administration of adeno-associated virus encoding omentin-1 upregulated the circulating omentin-1 level and attenuated glucocorticoid excess-induced cardiac hypertrophy and functional disorders. Overexpression of omentin-1 also improved cardiac mitochondrial function, including the reduction of lipid deposits, induction of mitochondrial biogenesis, and enhanced mitochondrial activities. Mechanistically, omentin-1 phosphorylated and activated the GSK3β pathway in the heart. From a study of 28 patients with Cushing’s syndrome and 23 healthy subjects, the plasma level of glucocorticoid was negatively correlated with omentin-1, and was positively associated with cardiac ejection fraction and fractional shortening. Collectively, the present study provided a novel role of omentin-1 in glucocorticoid excess-induced cardiac injuries and found that the omentin-1/GSK3β pathway was a potential therapeutic target in combating the side effects of glucocorticoid.

scholarly journals The Role of Multimodality Imaging in Left-Sided Prosthetic Valve Dysfunction

2022 ◽  
Vol 9 (1) ◽  
pp. 12
Author(s):  
Manuela Muratori ◽  
Laura Fusini ◽  
Maria Elisabetta Mancini ◽  
Gloria Tamborini ◽  
Sarah Ghulam Ali ◽  
...  
Keyword(s):  
Prosthetic Valve ◽  
Multimodality Imaging ◽  
Integrated Approach ◽  
Advanced Imaging ◽  
Valve Dysfunction ◽  
Clinical Presentations ◽  
Imaging Approach ◽  
Treatment Administration ◽  
Life Threatening

Prosthetic valve (PV) dysfunction (PVD) is a complication of mechanical or biological PV. Etiologic mechanisms associated with PVD include fibrotic pannus ingrowth, thrombosis, structural valve degeneration, and endocarditis resulting in different grades of obstruction and/or regurgitation. PVD can be life threatening and often challenging to diagnose due to the similarities between the clinical presentations of different causes. Nevertheless, identifying the cause of PVD is critical to treatment administration (thrombolysis, surgery, or percutaneous procedure). In this report, we review the role of multimodality imaging in the diagnosis of PVD. Specifically, this review discusses the characteristics of advanced imaging modalities underlying the importance of an integrated approach including 2D/3D transthoracic and transesophageal echocardiography, fluoroscopy, and computed tomography. In this scenario, it is critical to understand the strengths and weaknesses of each modality according to the suspected cause of PVD. In conclusion, for patients with suspected or known PVD, this stepwise imaging approach may lead to a simplified, more rapid, accurate and specific workflow and management.

scholarly journals Interventional Echocardiography: Field of Advanced Imaging to Support Structural Heart Interventions

2018 ◽  
Vol 12 (1) ◽  
pp. 22-27
Author(s):  
Roy Arjoon ◽  
Ashley Brogan ◽  
Lissa Sugeng
Keyword(s):  
Heart Disease ◽  
Transesophageal Echocardiography ◽  
3D Imaging ◽  
Multimodality Imaging ◽  
Structural Heart Disease ◽  
Advanced Imaging ◽  
Cardiac Defects ◽  
Interventional Echocardiography ◽  
2D And 3D

Multimodality imaging, particularly echocardiography, is paramount in planning and guiding structural heart disease interventions. Transesophageal echocardiography remains unique in its ability to provide real-time 2D and 3D imaging of valvular heart disease and anatomic cardiac defects, which directly impacts the strategy and outcome of these procedures. This review summarizes the role of transesophageal echocardiography in patients undergoing the most common structural heart disease interventions.

scholarly journals Cardiac Magnetic Resonance Imaging in Patients with COVID-19

2020 ◽  
pp. 1-3
Author(s):  
Ali Kemal Erenler ◽  
Ali Kemal Erenler ◽  
Seval Komut ◽  
Ahmet Baydin
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Tissue Characterization ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Resonance Imaging ◽  
Cardiac Damage

In the beginning of December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was determined in Wuhan, Hubei, China. Besides its predominant respiratory system-related symptoms, cardiovascular involvement has also been described in adults with direct and indirect cardiac injury. Pre-existing cardiovascular disease and cardiac risk factors have been shown to increase the risk of cardiac complications of COVID-19 infection. However, it is also known that healthy and asymptomatic COVID-19 survivors suffer cardiac damage-related complications. Cardiac Magnetic Resonance Imaging (CMRI) is known to be the reference non-invasive standard to present cardiac function and tissue characterization. It is recommended as an effective and efficient diagnostic imaging choice to obtain critical information for clinical diagnosis and decision-making. In this article, we sought the usefulness of CMRI in cardiovascular complications related to COVID-19.

scholarly journals Cardiovascular Complications of COVID-19 Infection

2021 ◽  
Vol 34 (9) ◽  
pp. 608
Author(s):  
Maria Ana Trêpa ◽  
António Hipólito Reis ◽  
Mario Oliveira
Keyword(s):  
Cardiac Arrhythmias ◽  
Myocardial Injury ◽  
Clinical Presentation ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Usual Practice ◽  
Coronary Syndromes ◽  
Worse Prognosis

Introduction: Reports of cardiovascular complications related to the COVID-19 infection have been frequent.Methods: Narrative review for relevant articles on the topic. The classic cardiovascular risk factors, like age, obesity, diabetes, and hypertension are associated with adverse outcomes in COVID-19 patients. Cardiovascular complications can have a diverse clinical presentation including silent myocardial injury, acute coronary syndromes, thromboembolism, cardiac arrhythmias, and heart failure. There are multiple mechanisms of cardiac injury that are not mutually exclusive. The approach to diagnosis and management should be carried out according to usual practice, while considering the particularities of COVID-19 infection.Conclusion: The interaction between SARS-CoV-2 and the heart is complex and is manifested in multiple ways. Regardless of the clinical presentation, cardiac complications convey a worse prognosis. Patients should be actively monitored and treated accordingly.

Abstract 15097: Covid-19 and Cardiovascular Complications: Pooled Analysis of Observational Studies

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vikramaditya Reddy Samala Venkata ◽  
Rahul Gupta ◽  
Surya Kiran Aedma ◽  
Bruce W Andrus
Keyword(s):  
Heart Failure ◽  
Cardiac Injury ◽  
Cardiovascular Complications ◽  
Pooled Analysis ◽  
Community Acquired Pneumonia ◽  
Cardiac Complications ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Icu Admission ◽  
Coronary Syndrome

Introduction: The pandemic of COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. Studies published so far raise concerns for cardiac complications in the infected individuals.The aim of our study is to determine the prevalence of cardiac complications in COVID-19. Methods: A systematic electronic search was performed in PubMed, Embase, Google Scholar. Retrospective studies having original hospitalized patient data were included in our study; while studies focussed only on intensive care unit (ICU) patients were excluded to prevent selection bias. Pooled analysis using a random effects model (Mantel-Haenszel test) was performed to look at the incidence of troponin elevation and association between elevated troponin levels, admission to the ICU and associated mortality. Results: 18 studies from 6 countries with over 9,500 patients were included in our analysis. Troponin elevation was reported in 16% (1123/7130) of patients. Heart failure was reported in 1 study and cardiac arrhythmia was reported in 2 studies. Elevated troponin levels were associated with higher rates of ICU admission (OR 26.17, 7.06-96.94; p<0.01) and mortality (OR 27.22, 10.24-72.33; P<0.01) (Figure 1). Information regarding the degree of troponin elevation and etiology associated with it (myocarditis vs acute coronary syndrome vs stress induced from critical illness) was not reported. Conclusion: Heart failure was reported in around 20% of the patients in 1 study, while troponin elevation was seen in 16% of the patients in 10 different studies. This is similar to the rate of cardiac complications reported in severe community acquired pneumonia. Troponin elevation in itself was associated with higher rates of ICU admission and mortality. This should alert the clinicians to check for troponin levels in these patients and triage them accordingly. More studies are needed to better understand specific mechanisms of cardiac injury in COVID-19 patients.

scholarly journals SARS CoV-2 Organotropism Associated Pathogenic Relationship of Gut-Brain Axis and Illness

2020 ◽  
Vol 7 ◽  
Author(s):  
Pottathil Shinu ◽  
Mohamed A. Morsy ◽  
Pran Kishore Deb ◽  
Anroop B. Nair ◽  
Manoj Goyal ◽  
...  
Keyword(s):  
Cardiac Injury ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Kidney Injury ◽  
Enteric Infection ◽  
Pneumonia Patient ◽  
Loss Of Appetite ◽  
Relationship Of ◽  
Insight Into ◽  
Maculopapular Exanthema

COVID-19 has resulted in a pandemic after its first appearance in a pneumonia patient in China in early December 2019. As per WHO, this global outbreak of novel COVID-19 has resulted in 28,329,790 laboratory-confirmed cases and 911,877 deaths which have been reported from 210 countries as on 12th Sep 2020. The major symptoms at the beginning of COVID-19 are fever (98%), tussis (76%), sore throat (17%), rhinorrhea (2%), chest pain (2%), and myalgia or fatigue (44%). Furthermore, acute respiratory distress syndrome (61.1%), cardiac dysrhythmia (44.4%), shock (30.6%), hemoptysis (5%), stroke (5%), acute cardiac injury (12%), acute kidney injury (36.6%), dermatological symptoms with maculopapular exanthema (36.1%), and death can occur in severe cases. Even though human coronavirus (CoV) is mainly responsible for the infections of the respiratory tract, some studies have shown CoV (in case of Severe Acute Respiratory Syndrome, SARS and Middle East Respiratory Syndrome, MERS) to possess potential to spread to extra-pulmonary organs including the nervous system as well as gastrointestinal tract (GIT). Patients infected with COVID-19 have also shown symptoms associated with neurological and enteric infection like disorders related to smell/taste, loss of appetite, nausea, emesis, diarrhea, and pain in the abdomen. In the present review, we attempt to evaluate the understanding of basic mechanisms involved in clinical manifestations of COVID-19, mainly focusing on interaction of COVID-19 with gut-brain axis. This review combines both biological characteristics of the virus and its clinical manifestations in order to comprehend an insight into the fundamental potential mechanisms of COVID-19 virus infection, and thus endorse in the advancement of prophylactic and treatment strategies.

scholarly journals COVID-19 and Cardiovascular Disease

2021 ◽  
Vol 128 (8) ◽  
pp. 1214-1236
Author(s):  
Mina K. Chung ◽  
David A. Zidar ◽  
Michael R. Bristow ◽  
Scott J. Cameron ◽  
Timothy Chan ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Cardiac Injury ◽  
Clinical Manifestations ◽  
Cell Receptor ◽  
Etiologic Agent ◽  
Angiotensin Converting Enzyme 2 ◽  
Circulating Cells ◽  
Host Cell Receptor ◽  
Cardiovascular Involvement ◽  
Extrapulmonary Manifestation

A pandemic of historic impact, coronavirus disease 2019 (COVID-19) has potential consequences on the cardiovascular health of millions of people who survive infection worldwide. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the etiologic agent of COVID-19, can infect the heart, vascular tissues, and circulating cells through ACE2 (angiotensin-converting enzyme 2), the host cell receptor for the viral spike protein. Acute cardiac injury is a common extrapulmonary manifestation of COVID-19 with potential chronic consequences. This update provides a review of the clinical manifestations of cardiovascular involvement, potential direct SARS-CoV-2 and indirect immune response mechanisms impacting the cardiovascular system, and implications for the management of patients after recovery from acute COVID-19 infection.

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