Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic

Jabri, Ahmad; Kalra, Ankur; Kumar, Ashish; Alameh, Anas; Adroja, Shubham; Bashir, Hanad; Nowacki, Amy S.; Shah, Rohan; Khubber, Shameer; Kanaa’N, Anmar; Hedrick, David P.; Sleik, Khaled; Mehta, Neil; Chung, Mina K.; Khot, Umesh N.; Kapadia, Samir; Puri, Rishi; Reed, Grant W.

doi:10.1001/jamanetworkopen.2020.14780

Cited by 210 publications

(221 citation statements)

References 10 publications

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“…In patients with myocarditis or inflammatory cardiomyopathies, inflammation is the primary cause of heart failure [5]. Moreover, cytokine-mediated inflammation has been implicated in acute stress-induced cardiomyopathy [6], an enigmatic entity that may be associated with major emotional or physical stress [7], and may also be a rare cause of myocardial injury in patients with coronavirus disease 2019 (COVID-19) [8,9]. In most other cases, activation of an inflammatory program reflects a reparative or protective response to other primary injurious processes.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Cytokines and Chemokines as Therapeutic Targets in Heart Failure

Hanna

Frangogiannis

2020

Cardiovasc Drugs Ther

231

170

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Heart failure exhibits remarkable pathophysiologic heterogeneity. A large body of evidence suggests that regardless of the underlying etiology, heart failure is associated with induction of cytokines and chemokines that may contribute to the pathogenesis of adverse remodeling, and systolic and diastolic dysfunction. The pro-inflammatory cytokines tumor necrosis factor (TNF)-α, interleukin (IL)-1, and IL-6 have been extensively implicated in the pathogenesis of heart failure. Inflammatory cytokines modulate phenotype and function of all myocardial cells, suppressing contractile function in cardiomyocytes, inducing inflammatory activation in macrophages, stimulating microvascular inflammation and dysfunction, and promoting a matrixdegrading phenotype in fibroblasts. Moreover, cytokine-induced growth factor synthesis may exert chronic fibrogenic actions contributing to the pathogenesis of heart failure with preserved ejection fraction (HFpEF). In addition to their role in adverse cardiac remodeling, some inflammatory cytokines may also exert protective actions on cardiomyocytes under conditions of stress. Chemokines, such as CCL2, are also upregulated in failing hearts and may stimulate recruitment of pro-inflammatory leukocytes, promoting myocardial injury, fibrotic remodeling, and dysfunction. Although experimental evidence suggests that cytokine and chemokine targeting may hold therapeutic promise in heart failure, clinical translation remains challenging. This review manuscript summarizes our knowledge on the role of TNF-α, IL-1, IL-6, and CCL2 in the pathogenesis of heart failure, and discusses the promises and challenges of targeted anti-cytokine therapy. Dissection of protective and maladaptive cellular actions of cytokines in the failing heart, and identification of patient subsets with overactive or dysregulated myocardial inflammatory responses are required for design of successful therapeutic approaches.

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Section: Introductionmentioning

confidence: 99%

Inflammatory Cytokines and Chemokines as Therapeutic Targets in Heart Failure

Hanna

Frangogiannis

2020

Cardiovasc Drugs Ther

231

170

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“…Similar to cancer, COVID-19 causes significant emotional and physical stress to affected individuals. A retrospective study of 1914 patients by Jabri et al reported a significant increase in the incidence of SCM during the COVID-19 period compared with the pre-pandemic time (7.8% vs 1.5-1.8%, respectively, p < 0.001) [43]. Although there is no published data at the time of this review regarding the incidence of SCM in patients with cancer and COVID-19, it is suspected to be increased due to the combination of these two risk factors.…”

Section: Stress Cardiomyopathy In Patients With Covid-19 and Cancermentioning

confidence: 99%

COVID-19 and Cardiovascular Health Among Patients with Cancer

2020

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Purpose of review The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to spread with rising new cases and deaths. Patients with cancer represent a uniquely vulnerable population not only with higher susceptibility to COVID-19 but also at increased risk for its complications. This review focuses on the implications of COVID-19 in the cardiovascular health of patients with cancer. Recent findings Patients more susceptible to COVID-19 with increased severity of disease include those with cancer and cardiovascular comorbidities. In addition, the cardiovascular complications of COVID-19 including acute myocardial injury, thromboembolism, cardiomyopathy, myocarditis, and pericardial disease overlap with many of those encountered during cancer treatment. Summary Despite the absence of large studies of patients with both cancer and cardiovascular disease, the incidence of cardiovascular complications in cancer patients with COVID-19 is expected to be high. This has implications for cardiac monitoring, chemotherapy administration, and the diagnosis and treatment of cardiovascular disease during COVID-19.

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“…19,20 An increased incidence of stress/Takotsubo cardiomyopathy (TCM) had been found in a cohort study of 1914 patients who presented with acute coronary syndrome during the COVID-19 pandemic as compared with the prepandemic period. 21 New onset cardiomyopathy has also been demonstrated in 33% of nonpregnant COVID-19 patients who required intensive care. 22 Viral genome has also been demonstrated in myocardial tissue of such patients in one study.…”

Section: Peripartum Cardiomyopathy In Pregnancy With Covid-19mentioning

confidence: 99%

Impact of COVID-19 on Cardio-obstetric Risk Indicators: Future Directions

Goyal

Chhabra

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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Cardiovascular illness is one the foremost causes of death in females. The goal of preventive medicine is to identify and target high-risk females belonging to the younger age group in order to prevent future onset of cardiovascular pathologies. Certain obstetric complications like idiopathic preterm birth, preeclampsia (PE), gestational diabetes and abruptio placentae mark their presence in the checklist of risk indicators for cardiovascular diseases (CVD) among the female population. Previous severe acute respiratory syndrome-1 (SARS-1) infections recorded a significant impact on maternal and fetal outcomes. In this article, we aim to focus on the incidence of cardiovascular risk indicators with the incessant novel Coronavirus disease-19 (COVID-19) pandemic in pregnant women and to provide recommendations for venous thromboembolism (VTE) prophylaxis in infected females. As the disease is novel and gradually unfolding to clinicians globally, the data and the publications are also evolving. Studies on COVID-19 in pregnancy has shown an increase in the number of preterm births, and PE with some reports on vertical transmission, but no significant increase in miscarriage, still births and teratogenicity. Preterm births appear more likely to be iatrogenic rather than idiopathic, owing to severity of infection or maternal/fetal safety. Causal association of virus with PE needs further analysis by large population studies, as both have common overlapping clinical and laboratory parameters. Direct placental involvement by virus leading on to PE or infection itself simulating PE needs further explication. Assessment of placental function, histopathological examination, and measurement of antiangiogenic factors are some of the suggested measures to differentiate further. Peripartum cardiomyopathy in COVID-19 positive pregnant females has not yet been actively explored, particularly in cases of clinical deterioration. Practical utilization of handheld point-of-care echocardiography machines stand in need for diagnosing myocardial dysfunction in this pandemic. COVID-19 infection and pregnancy together may impart a greater thromboembolism risk due to their inherent hypercoagulable states. All pregnant females with COVID-19 infection are candidates for VTE prophylaxis, both antepartum and postpartum depending on the severity of illness.

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Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic

Cited by 210 publications

References 10 publications

Inflammatory Cytokines and Chemokines as Therapeutic Targets in Heart Failure

Inflammatory Cytokines and Chemokines as Therapeutic Targets in Heart Failure

COVID-19 and Cardiovascular Health Among Patients with Cancer

Impact of COVID-19 on Cardio-obstetric Risk Indicators: Future Directions

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