Inflammation, abdominal aortic aneurysm enlargement and rupture. Lessons learned from the Covid19 pandemic.

IF 3.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Current Problems in Cardiology Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI:10.1016/j.cpcardiol.2025.103151
Antonio V Sterpetti, Francesca Miceli, Alessia Di Girolamo, Antonio Bozzani, Vittorio Arici, Marta Ascione, Luca Di Marzo
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引用次数: 0

Abstract

Patients with moderate-severe COVID19 infection suffer from several cardiovascular diseases: heart failure (3 %-33 %), myocardial ischemia (0.9 %-11 %), ventricular dysfunction (10 %-47 %), arrhythmias (9 %-17 %), venous thrombo-embolism (25 %) and arterial thrombosis (1 %-3 %). Although intracranial and coronary arterial aneurysms have been described in adults and children with COVID19, few reports have correlated COVID19 infection and sudden degeneration of aortic aneurysms and dissections. We analyzed the risk factor for enlargement and rupture of aortic aneurysms in patrients with moderate-severe COVID19 infection. Several COVID19 related mechanisms may impact aortic aneurysm progression: increased elastin and collagen digestion by enzymes triggered by viral spike proteins in ACE2-negative myeloid cells and/or by inflammatory cytokines; hypoxemia related to thrombosis of micro vessels of the aneurismal wall; dysregulation of the immune system. Patients with known arterial aneurysm may be at risk for sudden increase of dimensions and rupture during moderate-severe COVID19 infection.

炎症,腹主动脉瘤增大和破裂。从2019冠状病毒病大流行中吸取的教训。
中重度covid - 19感染患者伴有多种心血管疾病:心力衰竭(3%-33%)、心肌缺血(0.9%-11%)、心室功能障碍(10%-47%)、心律失常(9%-17%)、静脉血栓栓塞(25%)和动脉血栓形成(1%-3%)。虽然在成人和儿童中已经描述了covid - 19颅内和冠状动脉动脉瘤,但很少有报道将covid - 19感染与主动脉瘤的突然变性和夹层联系起来。我们分析了中重度covid - 19感染患者主动脉瘤扩大和破裂的危险因素。几种与covid - 19相关的机制可能影响主动脉瘤的进展:ace2阴性髓细胞中病毒刺突蛋白触发的酶和/或炎症细胞因子增加了弹性蛋白和胶原蛋白的消化;低氧血症与动脉瘤壁微血管血栓形成的关系免疫失调免疫系统失调已知动脉瘤患者在中重度感染期间可能面临尺寸突然增大和破裂的风险。
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来源期刊
Current Problems in Cardiology
Current Problems in Cardiology 医学-心血管系统
CiteScore
4.80
自引率
2.40%
发文量
392
审稿时长
6 days
期刊介绍: Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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