Background
Increasing studies demonstrated that the cardiac involvements are related to Coronavirus Disease 2019 (COVID‐19). Thus, we investigated the clinical characteristics of COVID‐19 patients and further determined the risk factors for cardiac involvements in them.
Methods and Results
We analyzed data from 102 consecutive laboratory‐confirmed and hospitalized COVID‐19 patients (52 women; age, 19–87 years). Epidemiological and demographic characteristics, clinical features, routine laboratory tests (including cardiac injury biomarkers), echocardiography, electrocardiography, chest imaging findings, management methods, and clinical outcomes were collected. Patients were divided into acute cardiac injury (ACI), with and without cardiac marker abnormities groups according to different level of cardiac markers. In this research, cardiac involvements were found in 72 of the 102 (70.6%) patients: tachycardia (n=20), electrocardiography abnormities (n=23), echocardiography abnormities (n=59), elevated myocardial enzymes (n=55), and acute myocardial injury (n=9). Eight ACI patients were aged >60 years; seven of them had two or more underlying comorbidities (hypertension, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease and chronic kidney disease). Novel coronavirus pneumonia (NCP) was much more severe in the ACI patients than in patients with non‐definite ACI (p<0.001). Multivariate analyses showed that C‐reactive protein (CRP) levels, old age, NCP severity, and underlying comorbidities were the risk factors for cardiac abnormalities in COVID‐19 patients.
Conclusions
Cardiac involvements are common in COVID‐19 patients. Elevated CRP levels, old age, underlying comorbidities, and NCP severity are the main risk factors for cardiac involvement in COVID‐19 patients. More attention should be given to cardiovascular protection during COVID‐19 treatment for mortality reduction.
The degree of sternal depression has a positive correlation with the degree of cardiac rotation in pectus excavatum. Helical CT is a valuable technique for evaluating the chest deformity and resultant cardiac rotation.
Acute myocardial infarction (AMI) is recognized as being a life-threatening event. Both microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) have been recognized as poor prognostic factors in myocardial infarct (MI) since they adversely affect left ventricular remodeling. MVO refers to small vessels changes that prevent adequate tissue perfusion despite revascularization whereas IMH is a severe form of MVO. A limited number of studies have demonstrated the segmental intervention time and the clinical factors in the presence of MVO and IMH. Therefore, we aimed in this study to determine the correlations of the intervention-associated and clinical indexes with malignant cardiovascular magnetic resonance (CMR) signs in patients with AMI.Sixty-three patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) within 12 hours were included in this study. A 3.0-T CMR scan was prescribed, and the subsequent image analysis was conducted by researchers blinded to the clinical index results. Late-gadolinium enhancement (LGE) and T2∗ sequences were mainly used for MVO and IMH identification and quantification.Patients exhibiting both MVO and IMH had the highest level of LGE (P < .001) and were significantly more frequently assigned to a pre-PPCI thrombolysis in myocardial infarction (TIMI) flow class of 0 (n=25, 89.3%). The MVO size correlated positively with the IMH size (r = 0.81, P < .01). A pre-PPCI TIMI flow class of 0 was found to reliably predict the presence of IMH (P < .001). Patients who received the intervention 4 to 6 hours after MI onset were more likely to exhibit MVO and IMH, although this trend was not statistically significant.We showed in our study that both MVO and IMH correlated with the degree of AMI and the pre-PPCI coronary flow, and both tended to occur more frequently in cases involving an interval of 4 to 6 hours between the onset of MI and the intervention. CMR is a reliable method for assessing MVO and IMH and its imaging features following gadolinium administration are characteristic. These findings stress the importance of using CMR in evaluating and improving the outcome of the medical management.
To clarify the anatomy of the peritoneal reflections of the left perihepatic region, the authors examined 95 cadavers. Thirty-eight were studied radiographically, 37 with sagittal dissection, and 20 with transverse dissection. In over 80% of the cadavers, the left triangular ligament of the liver separated the left suprahepatic space into anterior and posterior sections. The lesser omentum extended to the diaphragm, where its anterior layer reflected and continued as the posterior layer of the left triangular ligament. Thus, the posterior left suprahepatic space and the lesser sac were clearly separated by the lesser omentum and the stomach and over-lapped each other in three dimensions. The posterior left suprahepatic space was located anterosuperior to the lesser sac and in turn was continuous with the gastrohepatic space inferiorly. Carefully researched diagrams of both the midline sagittal and left parasagittal perihepatic spaces were developed. This information has clinical value when the radiologist is called on to drain a left perihepatic abscess.
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