Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA)
Por:
Cenko, E, Badimon, L, Bugiardini, R, Claeys, MJ, De Luca, G, de Wit, C, Derumeaux, G, Dorobantu, M, Duncker, DJ, Eringa, EC, Gorog, DA, Hassager, C, Heinzel, FR, Huber, K, Manfrini, O, Milicic, D, Oikonomou, E, Padro, T, Trifunovic-Zamaklar, D, Vasiljevic-Pokrajcic, Z, Vavlukis, M, Vilahur, G, Tousoulis, D
Publicada:
17 dic 2021
Resumen:
The cardiovascular system is significantly affected in coronavirus disease-19 (COVID-19). Microvascular injury, endothelial dysfunction, and thrombosis resulting from viral infection or indirectly related to the intense systemic inflammatory and immune responses are characteristic features of severe COVID-19. Pre-existing cardiovascular disease and viral load are linked to myocardial injury and worse outcomes. The vascular response to cytokine production and the interaction between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and angiotensin-converting enzyme 2 receptor may lead to a significant reduction in cardiac contractility and subsequent myocardial dysfunction. In addition, a considerable proportion of patients who have been infected with SARS-CoV-2 do not fully recover and continue to experience a large number of symptoms and post-acute complications in the absence of a detectable viral infection. This conditions often referred to as 'post-acute COVID-19' may have multiple causes. Viral reservoirs or lingering fragments of viral RNA or proteins contribute to the condition. Systemic inflammatory response to COVID-19 has the potential to increase myocardial fibrosis which in turn may impair cardiac remodelling. Here, we summarize the current knowledge of cardiovascular injury and post-acute sequelae of COVID-19. As the pandemic continues and new variants emerge, we can advance our knowledge of the underlying mechanisms only by integrating our understanding of the pathophysiology with the corresponding clinical findings. Identification of new biomarkers of cardiovascular complications, and development of effective treatments for COVID-19 infection are of crucial importance.
Filiaciones:
Cenko, E:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Via Giuseppe Massarenti 9, I-40134 Bologna, Italy
Badimon, L:
ICCC Res Inst Hosp Santa Creu & St Pau, Cardiovasc Program, CiberCV, IIB St Pau, Barcelona, Spain
Bugiardini, R:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Via Giuseppe Massarenti 9, I-40134 Bologna, Italy
Claeys, MJ:
Univ Hosp Antwerp, Dept Cardiol, Edegem, Belgium
De Luca, G:
Eastern Piedmont Univ, Cardiovasc Dept Cardiol, Osped Maggiore Carita, Novara, Italy
de Wit, C:
Univ Lubeck, Inst Physiol, Lubeck, Germany
Deutsch Zentrum Herz Kreislauf Forsch DZHK eV Ger, Partner Site Hamburg Kiel Lubeck, Lubeck, Germany
Derumeaux, G:
UPEC, IMRB U955, Creteil, France
Henri Mondor Teaching Hosp, AP HP, Dept Physiol, Creteil, France
Federat Hosp Univ SENEC, Creteil, France
Dorobantu, M:
Carol Davila Univ Med & Pharm, Bucharest, Romania
Duncker, DJ:
Univ Med Ctr Rotterdam, Thoraxctr, Dept Cardiol, Div Expt Cardiol,Erasmus MC, Rotterdam, Netherlands
Eringa, EC:
Univ Amsterdam, Amsterdam Cardiovasc Sci Inst, Dept Physiol, Med Ctr, Amsterdam, Netherlands
Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Dept Physiol, Maastricht, Netherlands
Gorog, DA:
Imperial Coll, Fac Med, Natl Heart & Lung Inst, London, England
Univ Hertfordshire, Dept Postgrad Med, Hatfield, Herts, England
Hassager, C:
Rigshosp, Dept Cardiol, Copenhagen, Denmark
Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
Heinzel, FR:
Charite Univ Med Berlin, Dept Cardiol, Campus Virchow Klinikum, Berlin, Germany
DZHK German Ctr Cardiovasc Res, Partner Site Berlin, Berlin, Germany
Berlin Inst Hlth, Berlin, Germany
Huber, K:
Wilhelminen Hosp, Med Dept 3, Cardiol & Intens Care Med, Vienna, Austria
Sigmund Freud Univ, Med Sch, Vienna, Austria
Manfrini, O:
Univ Bologna, Dept Expt Diagnost & Specialty Med, Via Giuseppe Massarenti 9, I-40134 Bologna, Italy
Milicic, D:
Univ Zagreb, Univ Hosp Ctr Zagreb, Dept Cardiovasc Dis, Zagreb, Croatia
Oikonomou, E:
Natl & Kapodistrian Univ Athens, Hippokrat Gen Hosp, Sch Med, Dept Cardiol, Athens, Greece
Padro, T:
ICCC Res Inst Hosp Santa Creu & St Pau, Cardiovasc Program, CiberCV, IIB St Pau, Barcelona, Spain
Trifunovic-Zamaklar, D:
Clin Ctr Serbia, Cardiol Dept, Belgrade, Serbia
Univ Belgrade, Fac Med, Belgrade, Serbia
Vasiljevic-Pokrajcic, Z:
Univ Belgrade, Fac Med, Belgrade, Serbia
Vavlukis, M:
Ss Cyril & Methodius Univ Skopje, Univ Clin Cardiol, Med Fac, Skopje, North Macedonia
Vilahur, G:
ICCC Res Inst Hosp Santa Creu & St Pau, Cardiovasc Program, CiberCV, IIB St Pau, Barcelona, Spain
Tousoulis, D:
Natl & Kapodistrian Univ Athens, Hippokrat Gen Hosp, Sch Med, Dept Cardiol, Athens, Greece
Green Published, Bronze
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