Heart and Lung Multimodality Imagicg in COVID-19

JACC-CARDIOVASCULAR IMAGING

卷:13

Review

Agricola, Eustachio^1,2  Beneduce, Alessandro^2,3  Esposito, Antonio^2,4  Ingallina, Giacomo^1,2  Palumbo, Diego^2,4  Palmisano, Anna^2,4  Ancona, Francesco^1,2  Baldetti, Luca^2,5  Pagnesi, Matteo^2,5  Melisurgo, Giulio^2,6  Zangrillo, Alberto^2,7  De Cobelli, Francesco^2,4 

[1] IRCCS San Raffaele Sci Inst, Cardiovasc Imaging Unit, Cardiothorac Vasc Dept, Milan, Italy

[2] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

[3] IRCCS San Raffaele Sci Inst, Intervent Cardiol Unit, Cardiothorac Vasc Dept, Milan, Italy

[4] IRCCS San Raffaele Sci Inst, Expt Imaging Ctr, Dept Radiol, Milan, Italy

[5] IRCCS San Raffaele Sci Inst, Cardiac Intens Care Unit, Cardiothorac Vasc Dept, Milan, Italy

[6] IRCCS San Raffaele Sci Inst, Cardiothorac Intens Care Unit, Cardiothorac Vasc Dept, Milan, Italy

[7] IRCCS San Raffaele Sci Inst, Anesthesia & Intens Care Unit, Anesthesia & Intens Care Dept, Milan, Italy

关键词: cardiac magnetic resonance;    chest x-ray;    computed tomography;    coronavirus;    COVID-19;    echocardiography;    lung ultrasound;    multimodality imaging;    SARS-CoV-2;   

DOI  :  10.1016/j.jcmg.2020.05.017

来源: Elsevier

【 摘 要 】

The severe acute respiratory syndrome-coronavirus-2 outbreak has rapidly reached pandemic proportions and has become a major threat to global health. Although the predominant clinical feature of coronavirus disease-2019 (COVID-19) is an acute respiratory syndrome of varying severity, ranging from mild symptomatic interstitial pneumonia to acute respiratory distress syndrome, the cardiovascular system can be involved in several ways. As many as 40% of patients hospitalized with COVID-19 have histories of cardiovascular disease, and current estimates report a proportion of myocardial injury in patients with COVID-19 of up to 12%. Multiple pathways have been suggested to explain this finding and the related clinical scenarios, encompassing local and systemic inflammatory responses and oxygen supply-demand imbalance. From a clinical point of view, cardiac involvement during COVID-19 may present a wide spectrum of severity, ranging from subclinical myocardial injury to well-defined clinical entities (myocarditis, myocardial infarction, pulmonary embolism, and heart failure), whose incidence and prognostic implications are currently largely unknown because of a significant lack of imaging data. Integrated heart and lung multimodality imaging plays a central role in different clinical settings and is essential in the diagnosis, risk stratification, and management of patients with COVID-19. The aims of this review are to summarize imaging-oriented pathophysiological mechanisms of lung and cardiac involvement in COVID-19 and to provide a guide for integrated imaging assessment in these patients. (C) 2020 by the American College of Cardiology Foundation.

【 授权许可】

Free