Long-Term Cardiovascular Diseases of Heatstroke: A Delayed Pathophysiology Outcome

Abstract

Heatstroke, defined as an elevated core body temperature above 40°C accompanied by altered mental status (e.g., confusion, disorientation, seizure and coma), is the most severe and lifethreatening condition in the spectrum of heat-related illnesses. Heatstroke patients may present with multi-organ dysfunction, but with rapid cooling and organ failure management, a full recovery often occurs within weeks. Long-term impairment is rare, with neurological impairment occurring most frequently. Despite an abundance of research on the persistent neurological and hepatic impairments, our knowledge of the long-term cardiovascular events in patients with heatstroke history is poor. We wondered whether heatstroke leads to cardiovascular diseases long after full recovery. Using Pubmed, Web of Science and Scopus, we gathered cohort studies looking at cardiovascular disease incidence or mortality as an outcome, including heatstroke animal studies. Based on the available literature, we found that a history of heatstroke is associated with an increased risk of cardiovascular diseases, including ischemic heart disease, heart failure and atrial fibrillation. Delayed metabolic disturbances occurring in exertional heatstroke mice are linked to the formation of atherosclerosis and the development of heart failure. These processes provide potential pathophysiological pathways leading to ischemic heart disease and heart failure in heatstroke patients. Our findings may massively impact our understanding of heatstroke recovery and the follow up of heatstroke patients. Therefore larger, more adequately powered cohort studies with cardiovascular disease as an outcome, in tandem with animal studies examining the underlying pathophysiology, are required to confirm or reject these findings and answer the proposed questions.

Interindividual variation of the organism - as an indicator for assessing the severity of heat stroke in an experimental study of Wistar rats

“…The organism includes compensatory mechanisms of heat release through sweating, tachycardia, and ultimately the activation of pro-in ammatory and in ammatory cytokines. Heatstroke is de ned as a state of elevated body temperature of 40.05°C and above this value, which is a consequence of overemphasized compensatory mechanisms and exhausted body reserves with interindividual variations (19,20). Through heat stroke, a condition occurs that in the range of 10 to 50% leads to death through cardiac dysfunction with global hypokinesia (21).…”

Modeling a 3-D multiscale blood-flow and heat-transfer framework for realistic vascular systems

“…The blood pressure and resultant blood circulation affects thermal response of body. Similarly, hyperthermia affects the cardiac response 36 . The VaPor model provides a novel method to simulate heat transfer in a mixed domain but lacks the ability to couple pressure gradient with assigned inter-domain mass transfer 28 .…”

Anti-Inflammatory and Anti-Oxidative Effects of Isorhamnetin for Protection Against Lung Injury in a Rat Model of Heatstroke in a Dry-Heat Environment

“…Its pathophysiological characteristics are severe hyperthermia (>40°C) and systemic inflammatory response, which can lead to multiple organ dysfunction and even death [ 1 ]. The 28-day and 2-year mortality rates can be as high as 58% and 71%, respectively [ 1 , 2 ]. Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are the most common complications of heatstroke [ 3 ].…”