解开复杂的相互作用:COVID-19 与心力衰竭:全面回顾

Dr. Dharani Swarna Deiveegan, Atinder Singh, Muhammad Ilyas Shazi, W. Rehman, Muhammad Rizwan Akram, Saliha Tauqeer, Darshankumar Raval, Ruqiya Bibi, Muhammad Subhan, Advaith Manoharasetty
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摘要

COVID-19 与心力衰竭(HF)之间的关联给临床管理带来了多方面的挑战和影响。本综述探讨了 COVID-19 与心力衰竭之间的流行病学、临床和机理关联,强调了这些疾病对患者预后的双向影响。COVID-19 可通过心肌损伤、炎症、血栓形成和免疫失调诱发或加重心房颤动,而原有的心房颤动会增加 COVID-19 的严重性和并发症。由于症状重叠,且需要区分 COVID-19 相关的肺部病理和心房颤动表现,这给诊断带来了挑战。了解潜在的病理生理机制(包括 ACE2 失调、细胞因子释放综合征和高凝状态)对于优化管理策略至关重要。早期识别、多学科协作、个性化治疗和患者教育对于管理 COVID-19 和高血压至关重要。本综述的见解为临床实践提供了参考,强调了量身定制的干预措施和持续研究的重要性,以减轻这些复杂的相互作用对患者预后和公共卫生措施的影响。
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Unraveling the Complex Interplay: COVID-19 and Heart Failure: A Comprehensive Review
The association between COVID-19 and heart failure (HF) presents multifaceted challenges and implications for clinical management. This comprehensive review explores the epidemiological, clinical, and mechanistic associations between COVID-19 and HF, emphasizing the bidirectional impact of these conditions on patient outcomes. COVID-19 can precipitate or exacerbate HF through myocardial injury, inflammation, thrombosis, and immune dysregulation, while pre-existing HF increases the severity and complications of COVID-19. Diagnostic challenges arise from overlapping symptoms and the need to differentiate between COVID-19-related lung pathology and HF manifestations. Understanding the underlying pathophysiological mechanisms, including ACE2 dysregulation, cytokine release syndrome, and hypercoagulability, is crucial for optimizing management strategies. Early identification, multidisciplinary collaboration, personalized treatment, and patient education are essential to managing COVID-19 and HF. Insights from this review inform clinical practice, highlighting the importance of tailored interventions and ongoing research to mitigate the impact of these complex interactions on patient outcomes and public health initiatives.
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