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Management of Myocardial and Pericardial Diseases under COVID-19 Pandemic

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 December 2023) | Viewed by 5805

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Special Issue Editors

Dr. Aneta Aleksova

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Guest Editor

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
Interests: COVID-19; vitamin D; cardiovascular diseases; myocardial infarction; cardiomyopathies; heart failure; biomarkers; cytokine; inflammasome; risk stratification
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Dr. Milijana Janjušević

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Guest Editor

1. Deparment of Medical Surgical and Health Science, University of Trieste, Trieste, Italy
2. Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), 34148 Trieste, Italy
Interests: COVID-19; cardiovascular disease; heart failure; biomarkers; cytokine; inflammation; oxidative stress; endothelial dysfunction
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the last two years, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly become the leading health concern worldwide. At the very beginning of the COVID-19 pandemic, it was immediately apparent that pre-existing cardiovascular diseases increase individuals’ susceptibility to SARS-CoV-2 infection and their risk of adverse outcomes due to an imbalance in ACE/ACE2 levels. Furthermore, COVID-19 itself induces cardiovascular complications, including myocardial infarction, heart failure, arrhythmia, and myocarditis. The close relationship between SARS-CoV-2 and cardiovascular diseases raises a number of clinical questions concerning the optimal management of high-risk patients. For example, interactions between antiviral medications and other drugs could negatively affect the cardiovascular system; therefore, the interruption or compliance of chronic drug therapy, such as ACE/ARBi, as well as the side effects of vaccines on pharmacological therapies, should be considered.

This Special Issue will explore the latest findings on drug therapy for patients with concurrent cardiovascular disease and COVID-19. With this aim in mind, clinical studies, trials, reviews and meta-analyses will all be considered, particularly those with an emphasis on correct diagnosis, useful biomarkers and clinical–instrumental parameters, therapeutic approaches, risk stratification and patient monitoring during and after their infection with COVID-19.

Dr. Aneta Aleksova
Dr. Milijana Janjušević
Guest Editors

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Keywords

COVID-19
cardiovascular diseases
cardiomyopathies
myocardial infarction
myocarditis
pericarditis
pulmonary embolism
risk stratification
outcome
diagnostic and therapeutic approaches
vitamin D

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Research

11 pages, 1187 KiB

Open AccessArticle

Artificial Intelligence-Powered Left Ventricular Ejection Fraction Analysis Using the LVivoEF Tool for COVID-19 Patients

by Ziv Dadon, Yoed Steinmetz, Nir Levi, Amir Orlev, Daniel Belman, Adi Butnaru, Shemy Carasso, Michael Glikson, Evan Avraham Alpert and Shmuel Gottlieb

J. Clin. Med. 2023, 12(24), 7571; https://doi.org/10.3390/jcm12247571 - 8 Dec 2023

Cited by 3 | Viewed by 1262

Abstract

We sought to prospectively investigate the accuracy of an artificial intelligence (AI)-based tool for left ventricular ejection fraction (LVEF) assessment using a hand-held ultrasound device (HUD) in COVID-19 patients and to examine whether reduced LVEF predicts the composite endpoint of in-hospital death, advanced ventilatory support, shock, myocardial injury, and acute decompensated heart failure. COVID-19 patients were evaluated with a real-time LVEF assessment using an HUD equipped with an AI-based tool vs. assessment by a blinded fellowship-trained echocardiographer. Among 42 patients, those with LVEF < 50% were older with more comorbidities and unfavorable exam characteristics. An excellent correlation was demonstrated between the AI and the echocardiographer LVEF assessment (0.774, p < 0.001). Substantial agreement was demonstrated between the two assessments (kappa = 0.797, p < 0.001). The sensitivity, specificity, PPV, and NPV of the HUD for this threshold were 72.7% 100%, 100%, and 91.2%, respectively. AI-based LVEF < 50% was associated with worse composite endpoints; unadjusted OR = 11.11 (95% CI 2.25–54.94), p = 0.003; adjusted OR = 6.40 (95% CI 1.07–38.09, p = 0.041). An AI-based algorithm incorporated into an HUD can be utilized reliably as a decision support tool for automatic real-time LVEF assessment among COVID-19 patients and may identify patients at risk for unfavorable outcomes. Future larger cohorts should verify the association with outcomes. Full article

(This article belongs to the Special Issue Management of Myocardial and Pericardial Diseases under COVID-19 Pandemic)

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15 pages, 719 KiB

Open AccessArticle

The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19

by Larisa Anghel, Bogdan-Sorin Tudurachi, Andreea Leonte, Radu Andy Sascău, Ioana Mădălina Zota, Amin Bazyani, Grigore Tinică and Cristian Stătescu

J. Clin. Med. 2022, 11(21), 6542; https://doi.org/10.3390/jcm11216542 - 4 Nov 2022

Cited by 5 | Viewed by 1713

Abstract

The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mortality. Comparing the two groups of patients with STEMI separated according to the presence of SARS-CoV-2 infections, it was observed that COVID-19 patients were more likely to present with dyspnea (82.43% vs. 61.41%, p = 0.048) and cardiogenic shock (10.52% vs. 5.40%, p = 0.012). A longer total ischemia time was observed in COVID-19 patients, and they were twice as likely to undergo coronary angiography more than 12 hours after the onset of symptoms (19.29% vs. 10.13%, p = 0.024). In 10 of 57 COVID-19-positive patients, a primary PCI was not necessary, and only thromboaspiration was performed (17.54% vs. 2.70%, p < 0.001). Platelet level was inversely correlated (r = −0.512, p = 0.025) with a higher risk of coronary thrombosis without an atherosclerotic lesion. Using a cut-off value of 740 ng/ml, D-dimers predicted a higher risk of coronary thrombosis, with a sensitivity of 80% and a specificity of 66% (ROC area under the curve: 0.826, 95% CI: 0.716–0.935, p = 0.001). These are novel findings that raise the question of whether more aggressive antithrombotic therapy is necessary for selected COVID-19 and STEMI patients. Full article

(This article belongs to the Special Issue Management of Myocardial and Pericardial Diseases under COVID-19 Pandemic)

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12 pages, 724 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

by Javier de Miguel-Diez, Rodrigo Jimenez-Garcia, Jose M. de Miguel-Yanes, Valentin Hernández-Barrera, David Carabantes-Alarcon, Jose J. Zamorano-Leon, Concepción Noriega and Ana Lopez-de-Andres

J. Clin. Med. 2022, 11(13), 3924; https://doi.org/10.3390/jcm11133924 - 5 Jul 2022

Viewed by 1902

Abstract

(1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; p = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; p = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for “any cardiac procedure” (1.18, 95% CI 1.03–1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD. Full article

(This article belongs to the Special Issue Management of Myocardial and Pericardial Diseases under COVID-19 Pandemic)

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Management of Myocardial and Pericardial Diseases under COVID-19 Pandemic

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