Τίτλος:
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)
Περίληψη:
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.
Συγγραφείς:
Cenko, Edina
Badimon, Lina
Bugiardini, Raffaele
Claeys, Marc
J.
De Luca, Giuseppe
de Wit, Cor
Derumeaux, Genevieve and
Dorobantu, Maria
Duncker, Dirk J.
Eringa, Etto C.
Gorog,
Diana A.
Hassager, Christian
Heinzel, Frank R.
Huber, Kurt
and Manfrini, Olivia
Milicic, Davor
Oikonomou, Evangelos and
Padro, Teresa
Trifunovic-Zamaklar, Danijela and
Vasiljevic-Pokrajcic, Zorana
Vavlukis, Marija
Vilahur, Gemma and
Tousoulis, Dimitris
