Borlotti Alessandra, Thomaides-Brears Helena, Georgiopoulos Georgios, Banerjee Rajarshi, Robson Matthew D, Fusco Dahlene N, Masci Pier-Giorgio
Perspectum Ltd., Oxford, United Kingdom.
School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
Front Cardiovasc Med. 2022 Apr 7;9:854750. doi: 10.3389/fcvm.2022.854750. eCollection 2022.
In COVID-19 the development of severe viral pneumonia that is coupled with systemic inflammatory response triggers multi-organ failure and is of major concern. Cardiac involvement occurs in nearly 60% of patients with pre-existing cardiovascular conditions and heralds worse clinical outcome. Diagnoses carried out in the acute phase of COVID-19 rely upon increased levels of circulating cardiac injury biomarkers and transthoracic echocardiography. These diagnostics, however, were unable to pinpoint the mechanisms of cardiac injury in COVID-19 patients. Identifying the main features of cardiac injury remains an urgent yet unmet need in cardiology, given the potential clinical consequences. Cardiovascular magnetic resonance (CMR) provides an unparalleled opportunity to gain a deeper insight into myocardial injury given its unique ability to interrogate the properties of myocardial tissue. This endeavor is particularly important in convalescent COVID-19 patients as many continue to experience chest pain, palpitations, dyspnea and exertional fatigue, six or more months after the acute illness. This review will provide a critical appraisal of research on cardiovascular damage in convalescent adult COVID-19 patients with an emphasis on the use of CMR and its value to our understanding of organ damage.
在新冠肺炎中,严重病毒性肺炎的发展与全身炎症反应相结合,引发多器官功能衰竭,这是主要关注点。近60%患有心血管疾病的患者会出现心脏受累,这预示着更差的临床结果。在新冠肺炎急性期进行的诊断依赖于循环心脏损伤生物标志物水平的升高和经胸超声心动图检查。然而,这些诊断方法无法确定新冠肺炎患者心脏损伤的机制。鉴于潜在的临床后果,确定心脏损伤的主要特征仍然是心脏病学中迫切但未得到满足的需求。心血管磁共振成像(CMR)凭借其独特的询问心肌组织特性的能力,为深入了解心肌损伤提供了无与伦比的机会。这一努力在康复期新冠肺炎患者中尤为重要,因为许多患者在急性疾病发生六个月或更长时间后仍持续经历胸痛、心悸、呼吸困难和运动性疲劳。本综述将对康复期成年新冠肺炎患者心血管损伤的研究进行批判性评估,重点关注CMR的应用及其对我们理解器官损伤的价值。