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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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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Abstract •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]
AbstractList •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]
• 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.
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.
Highlights•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.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.
Author Cooper, Leslie T.
Hanff, Thomas C.
Chahal, C. Anwar A.
Siripanthong, Bhurint
Ferrari, Victor A.
Asatryan, Babken
Mohiddin, Saidi A.
Nazarian, Saman
Deo, Rajat
Ricci, Fabrizio
Muser, Daniele
Khanji, Mohammed Y.
Chatha, Salman R.
Santangeli, Pasquale
Author_xml – sequence: 1
  givenname: Bhurint
  surname: Siripanthong
  fullname: Siripanthong, Bhurint
  organization: School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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  givenname: Babken
  orcidid: 0000-0002-0050-5717
  surname: Asatryan
  fullname: Asatryan, Babken
  organization: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
– sequence: 3
  givenname: Thomas C.
  surname: Hanff
  fullname: Hanff, Thomas C.
  organization: University of Utah Health, Salt Lake City, Utah, USA
– sequence: 4
  givenname: Salman R.
  surname: Chatha
  fullname: Chatha, Salman R.
  organization: Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
– sequence: 5
  givenname: Mohammed Y.
  surname: Khanji
  fullname: Khanji, Mohammed Y.
  organization: Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
– sequence: 6
  givenname: Fabrizio
  orcidid: 0000-0002-1401-6623
  surname: Ricci
  fullname: Ricci, Fabrizio
  organization: Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
– sequence: 7
  givenname: Daniele
  surname: Muser
  fullname: Muser, Daniele
  organization: Dipartimento Cardiotoracico, U.O.C. di Cardiologia, Presidio Ospedaliero Universitario “Santa Maria Della Misericordia,” Udine, Italy
– sequence: 8
  givenname: Victor A.
  surname: Ferrari
  fullname: Ferrari, Victor A.
  organization: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
– sequence: 9
  givenname: Saman
  surname: Nazarian
  fullname: Nazarian, Saman
  organization: Electrophysiology Section, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
– sequence: 10
  givenname: Pasquale
  surname: Santangeli
  fullname: Santangeli, Pasquale
  organization: Electrophysiology Section, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
– sequence: 11
  givenname: Rajat
  surname: Deo
  fullname: Deo, Rajat
  organization: Electrophysiology Section, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
– sequence: 12
  givenname: Leslie T.
  surname: Cooper
  fullname: Cooper, Leslie T.
  organization: Mayo Clinic, Jacksonville, Florida, USA
– sequence: 13
  givenname: Saidi A.
  surname: Mohiddin
  fullname: Mohiddin, Saidi A.
  organization: Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
– sequence: 14
  givenname: C. Anwar A.
  surname: Chahal
  fullname: Chahal, C. Anwar A.
  email: drachahal@doctors.org.uk
  organization: Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom
BackLink https://www.ncbi.nlm.nih.gov/pubmed/35165665$$D View this record in MEDLINE/PubMed
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Cardiovascular Research - Hypertension
Institutionen för kliniska vetenskaper, Malmö
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Issue 3
Keywords 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
Language English
License This is an open access article under the CC BY-NC-ND license.
2022 The Authors.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Mr Siripanthong and Dr Asatryan contributed equally to this work and are joint first authors.
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Snippet •COVID-19 myocardial injury results from immune and hypercoagulability responses.•Long-term cardiac consequences of COVID-19 include structural and functional...
Highlights•COVID-19 myocardial injury results from immune and hypercoagulability responses. •Long-term cardiac consequences of COVID-19 include structural and...
The mechanisms of coronavirus disease-2019 (COVID-19)-related myocardial injury comprise both direct viral invasion and indirect (hypercoagulability and...
• COVID-19 myocardial injury results from immune and hypercoagulability responses. • Long-term cardiac consequences of COVID-19 include structural and...
The mechanisms of coronavirus disease-2019 (COVID-19)–related myocardial injury comprise both direct viral invasion and indirect (hypercoagulability and...
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SubjectTerms 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
Title The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury
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https://dx.doi.org/10.1016/j.jacbts.2021.10.011
https://www.ncbi.nlm.nih.gov/pubmed/35165665
https://www.proquest.com/docview/2629055792
https://pubmed.ncbi.nlm.nih.gov/PMC8828362
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