The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury

•COVID-19 myocardial injury results from immune and hypercoagulability responses.•Long-term cardiac consequences of COVID-19 include structural and functional changes.•Myocarditis after COVID-19 vaccination is uncommon (highest risk in teenage males).•Larger population-based studies are necessary to...

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Bibliographic Details
Published in:JACC. Basic to translational science Vol. 7; no. 3; pp. 294 - 308
Main Authors: Siripanthong, Bhurint, Asatryan, Babken, Hanff, Thomas C., Chatha, Salman R., Khanji, Mohammed Y., Ricci, Fabrizio, Muser, Daniele, Ferrari, Victor A., Nazarian, Saman, Santangeli, Pasquale, Deo, Rajat, Cooper, Leslie T., Mohiddin, Saidi A., Chahal, C. Anwar A.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.03.2022
Elsevier
Subjects:
athlete
Cardiology and Cardiovascular Disease
Cardiovascular
cardiovascular magnetic resonance imaging
Clinical Medicine
COVID-19
inflammation
Kardiologi och kardiovaskulära sjukdomar
Klinisk medicin
Medical and Health Sciences
Medicin och hälsovetenskap
myocardial injury
myocarditis
State-of-the-Art Review
sudden cardiac death
troponin
athlete
myocarditis
CMR
sudden cardiac death
LGE
COVID-19
cardiovascular magnetic resonance imaging
CT
SARS-CoV-2
myocardial injury
troponin
inflammation
MI
coronavirus disease-2019
severe acute respiratory syndrome coronavirus-2
myocardial infarction
cardiovascular magnetic resonance
Computerized Tomography
late gadolinium enhancement
SARS-CoV-2, severe acute respiratory syndrome coronavirus-2
MI, myocardial infarction
CT, Computerized Tomography
LGE, late gadolinium enhancement
CMR, cardiovascular magnetic resonance
COVID-19, coronavirus disease-2019
ISSN:2452-302X, 2452-302X
Online Access:Get full text
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Summary:•COVID-19 myocardial injury results from immune and hypercoagulability responses.•Long-term cardiac consequences of COVID-19 include structural and functional changes.•Myocarditis after COVID-19 vaccination is uncommon (highest risk in teenage males).•Larger population-based studies are necessary to validate these early results. The mechanisms of coronavirus disease-2019 (COVID-19)–related myocardial injury comprise both direct viral invasion and indirect (hypercoagulability and immune-mediated) cellular injuries. Some patients with COVID-19 cardiac involvement have poor clinical outcomes, with preliminary data suggesting long-term structural and functional changes. These include persistent myocardial fibrosis, edema, and intraventricular thrombi with embolic events, while functionally, the left ventricle is enlarged, with a reduced ejection fraction and new-onset arrhythmias reported in a number of patients. Myocarditis post-COVID-19 vaccination is rare but more common among young male patients. Larger studies, including prospective data from biobanks, will be useful in expanding these early findings and determining their validity. [Display omitted]
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Mr Siripanthong and Dr Asatryan contributed equally to this work and are joint first authors.
ISSN:2452-302X
2452-302X
DOI:10.1016/j.jacbts.2021.10.011