COVID-19 患者的 Takotsubo 综合征:系统回顾

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Xiaojia Lu MD , Catherine Teng MD , Peng Cai MSc , Jing Liang MD , Yanxuan Wang MD , Hawa Abu MD, PhD , Yuan Jia Wang , John E. Madias MD , Kan Liu MD, PhD, MBA , Qi Liu PhD , Pengyang Li MD
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引用次数: 0

摘要

背景呼吸系统疾病是诱发塔可次波综合征(TTS)的主要生理因素,并预示着更严重的后果。然而,冠状病毒病-2019感染(COVID-19)患者的TTS数据有限。方法我们检索了PubMed、Embase和Cochrane图书馆数据库中2019-2022年间描述COVID-19肺炎(TTS-COVID)患者TTS的病例报告。我们总结了临床数据和结果,并与以COVID-19以外的急性呼吸道疾病为诱因的TTS患者(TTS-急性呼吸道疾病)和无呼吸道疾病的TTS患者(TTS-无呼吸道疾病)进行了比较。结果TTS-COVID患者的死亡率(26.0%)高于TTS-急性呼吸道疾病患者(5.7%)或TTS-无呼吸道疾病患者(4.2%;两者的P均为0.001)。男性在 TTS-COVID 中所占比例(33.3%)高于 TTS 无呼吸系统疾病患者(9.1%;P <0.001)。COVID 患者的 TTS 表现不典型(呼吸困难 [70.3%] 和咳嗽 [40.6%]);胸痛患者很少(23.4%)。心血管风险因素在 TTS-COVID 组群中很常见,但与其他两组相比,该组中服用心脏保护药物的患者较少。TTS-COVID 组使用儿茶酚胺的比例(37.7%)高于 TTS 无呼吸系统疾病组(10.9%;P < 0.001)。结论与 TTS-acute respiratory disease 组或 TTS-no respiratory disease 组相比,COVID-19 患者发生 TTS 的死亡率高且具有独特特征。了解 COVID-19 中 TTS 的病理生理学有助于预防 TTS 并指导治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Takotsubo Syndrome in Patients With COVID-19: A Systematic Review

Takotsubo Syndrome in Patients With COVID-19: A Systematic Review

Background

Respiratory conditions are major physical triggers of takotsubo syndrome (TTS) and portend worse outcomes. However, data on TTS in patients with coronavirus disease-2019 infection (COVID-19) are limited.

Methods

We searched PubMed, Embase, and Cochrane Library databases for case reports for the period 2019-2022 describing TTS in patients with COVID-19 pneumonia (TTS-COVID). We summarized the clinical data and outcomes and compared them to those in patients with TTS with an acute respiratory disease other than COVID-19 as a trigger (TTS-acute respiratory disease) and those with TTS with no respiratory disease (TTS-no respiratory disease).

Results

The mortality rate was higher in those with TTS-COVID (26.0%) than those with TTS-acute respiratory disease (5.7%) or TTS-no respiratory disease (4.2%; P < 0.001 for both). The proportion of men was higher in TTS-COVID (33.3%) than it was in TTS-no respiratory disease (9.1%; P < 0.001). The manifestations of TTS in COVID patients were atypical (dyspnea [70.3%] and cough [40.6%]); few had chest pain (23.4%). Cardiovascular risk factors were common in the TTS-COVID cohort, but fewer patients were on cardioprotective medications in this group than in the other 2 groups. Level of catecholamine use was higher in the TTS-COVID group (37.7%) than it was in the TTS-no respiratory disease (10.9%; P < 0.001) group. Apical ballooning (72.6%) was the most common TTS subtype, and basal segment type was seen in 11.0% of TTS-COVID patients.

Conclusions

COVID-19 patients who developed TTS had high mortality rates and unique features, compared with those in the TTS-acute respiratory disease group or the TTS-no respiratory disease group. Understanding the pathophysiology of TTS in COVID-19 may help prevent TTS and direct therapy in this setting.

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来源期刊
CJC Open
CJC Open Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
143
审稿时长
60 days
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