Transient cardiac injury during H7N9 infection

Han, Jie; Mou, Yun; Dong, Yan; Zhang, Yuntao; Jiang, Tianan; Zhang, Yuanyuan; Zhou, Yunyun; Sun, Zewei; Jiang, Dongmei; Chen, Yan; Liang, Weifeng; Li, Lanjuan

doi:10.1111/eci.12386

Cited by 19 publications

(25 citation statements)

References 22 publications

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“…11–13 Similarly, acute myocardial injury has been demonstrated in 7.2%–12% of patients with COVID-19 in preliminary reports, 8 14 with a higher prevalence among those requiring intensive care. Troponin elevation was transient in some studies 13 and associated with reversible subclinical left ventricular diastolic impairment in SARS, 3 suggesting that it may be an innocent bystander phenomenon. However, patients with COVID-19 frequently present with initial cardiovascular symptoms, such as palpitations and chest tightness, 4 and fulminant myocarditis has been reported as a cause of death, 15 suggesting a complex interaction between this respiratory virus and the cardiovascular system.…”

Section: Discussionmentioning

confidence: 99%

“…10 Troponin is a widely accepted biomarker of myocardial injury, and elevated serum levels have been a notable feature during recent epidemics of respiratory virus infections. [11][12][13] Similarly, acute myocardial injury has been demonstrated in 7.2%-12% of patients with COVID-19 in preliminary reports, 8 14 with a higher prevalence among those requiring intensive care. Troponin elevation was transient in some studies 13 and associated with reversible subclinical left ventricular diastolic impairment in SARS, 3 suggesting that it may be an innocent bystander phenomenon.…”

Section: Special Populationsmentioning

confidence: 99%

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Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis

Wei

Huang

Xiong

et al. 2020

Heart

177

152

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ObjectiveWe sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with covid-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic).MethodsWe prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit.ResultsA total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34–62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury.ConclusionAcute myocardial injury is common in patients with covid-19 and is associated with adverse prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Special Populationsmentioning

confidence: 99%

Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis

Wei

Huang

Xiong

et al. 2020

Heart

177

152

View full text Add to dashboard Cite

show abstract

“…Little is known about the role of STE in the evaluation of IVI-related myocarditis. Han et al evaluated cardiac injury caused by avian-origin influenza A virus (H7N9) infection and observed that patients who developed cardiovascular complications, including overt heart failure, had elevated cardiac troponin I and decreased GLS [27]. With the results of their study taken into account, our finding of GLS remaining unchanged during follow-up may not be surprising.…”

Section: Discussionmentioning

confidence: 75%

Transient depression of myocardial function after influenza virus infection: A study of echocardiographic tissue imaging

et al. 2019

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Background Influenza virus infection (IVI) was reported to be associated with minor cardiac changes, mostly those detected on electrocardiogram with and without elevated blood markers of myocardial injury; however, the characteristics of myocardial involvement in association with IVI are poorly understood. This study used echocardiographic tissue imaging (tissue Doppler, strain, and strain rate) to evaluate changes in left atrial (LA) and left ventricular (LV) myocardial function after IVI. Methods and results We examined 20 adult individuals (mean age, 43 years) at 2 and 4 weeks after diagnosis of IVI. For myocardial functional variables, we obtained LV global longitudinal strain (GLS), LV early diastolic strain rate (e'sr), LA strain, and LA stiffness (E/e’/LA strain), in addition to data on tissue Doppler (s’, e’, and a’) and myocardial performance index. Blood markers of myocardial injury were also examined. During follow-up, there were no significant changes in global chamber function such as LV ejection fraction, E/e’, and LA volume. However, significant changes in myocardial function were observed, namely, in s’ (8.0 ± 1.6 cm/s to 9.3 ± 1.5 cm/s; p = 0.01), e’ (10.2 ± 2.8 cm/s to 11.4 ± 3.0 cm/s; p < 0.001), e’sr (1.43 ± 0.44 1/s to 1.59 ± 0.43 1/s; p = 0.005), and LA strain (35 ± 8% to 40 ± 12%; p = 0.025), and the myocardial performance index (0.52 ± 0.20 to 0.38 ± 0.09; p = 0.009), but not in a’, LA stiffness, or GLS. Cardiac troponin T and creatinine kinase isoenzyme MB were not elevated significantly at any examination. Conclusions Myocardial dysfunction during IVI recovery appeared to be transient particularly in the absence of myocardial injury. Echocardiographic tissue imaging may be useful to detect subclinical cardiac changes in association with IVI.

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“…Though this may contrast with a study done by Lewes et al where myocarditis and myalgia occurred in two out of seven patients with mild influenza infection, the very small sample size of Lewes et al study warrants more studies to confirm the results and is misleading [26]. A study by Han et al showed that out of 40 patients infected with lab-confirmed avian-influenza A H7N9, half of the patients presented with cardiovascular complications like hypotension (47.5%) and heart failure (40.0%) but the infection by H7N9 is common in birds and less common in humans [35].…”

Section: Figure 1: Studies On Influenza Myocarditis (Mortality and Numentioning

confidence: 98%

Influenza Myocarditis: A Literature Review

Baral¹,

Adhikari²,

Adhikari³

et al. 2020

Cureus

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Transient cardiac injury during H7N9 infection

Abstract: H7N9 virus exerts a transient impairment on the cardiovascular system. Patients with a higher APACHE II score are more susceptible to cardiac damage.

Cited by 19 publications

References 22 publications

Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis

Acute myocardial injury is common in patients with COVID-19 and impairs their prognosis

Transient depression of myocardial function after influenza virus infection: A study of echocardiographic tissue imaging

Influenza Myocarditis: A Literature Review

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