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Medicina
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Heart Failure in the Era of COVID 19
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Heart Failure in the Era of COVID 19

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (16 December 2021) | Viewed by 23711

Special Issue Editor

Dr. Arnon Blum

E-Mail Website
Guest Editor
Baruch Padeh Medical Center, Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan 15208, Israel
Interests: endothelial progenitor stem cell research; endothelial function and vascular biology; heart failure and preventive cardiology; stem cell transplantation for cardiovascular disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is now evident that the mechanisms leading to heart failure could be multifactorial. We are used to think about heart failure as an ischemic heart disease leading to heart failure, but we are now recognizing more and more patients with diabetes and old patients with non-ischemic heart failure, with preserved ejection fraction, and this is not well understood.

Now, in the COVID-19 pandemic we face another scenario of acute severe heart failure, with multi-organ failure and a cytokine storm, which can represent another story, and that is the viral (“idiopathic”?) myocarditis and viral induced myocardial damage to the heart. This Issue intends to provide an interesting cutting-edge forum to focus on acute and chronic heart failure in the face of the COVID-19 pandemic.

Dr. Arnon Blum
Guest Editor

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Keywords

  • heart failure
  • preserved and impaired heart failure
  • myocarditis
  • ischemic
  • diabetic heart disease
  • viral induced heart failure
  • cytokines
  • multi-organ failure

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Published Papers (6 papers)

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Research

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14 pages, 2135 KiB  
Article
Contribution of Global and Regional Longitudinal Strain for Clinical Assessment of HFpEF in Coronary and Hypertensive Patients
by Gheorghe Stoichescu-Hogea, Florina Nicoleta Buleu, Ruxandra Christodorescu, Raluca Sosdean, Anca Tudor, Andreea Ember, Daniel Miron Brie and Simona Drăgan
Medicina 2021, 57(12), 1372; https://doi.org/10.3390/medicina57121372 - 17 Dec 2021
Cited by 5 | Viewed by 2514
Abstract
Background: Contribution of global and regional longitudinal strain (GLS) for clinical assessment of patients with heart failure with preserved ejection fraction (HFpEF) is not well established. We sought to evaluate subclinical left ventricular dysfunction secondary to coronary artery disease (CAD) in HFpEF patients [...] Read more.
Background: Contribution of global and regional longitudinal strain (GLS) for clinical assessment of patients with heart failure with preserved ejection fraction (HFpEF) is not well established. We sought to evaluate subclinical left ventricular dysfunction secondary to coronary artery disease (CAD) in HFpEF patients compared with hypertensive patients and age-matched healthy subjects. Material and methods: This was a retrospective study that included 148 patients (group 1 = 62 patients with HFpEF, group 2 = 46 hypertensive patients, and group 3 = 40 age-matched control subjects). Peak systolic segmental, regional (basal, mid, and apical), and global longitudinal strain were assessed for each study group using two-dimensional speckle-tracking echocardiography (2D-STE). Results: GLS values presented statistically significant differences between the three groups (p < 0.001); markedly increased values (more negative) were observed in the control group (−20.2 ± 1.4%) compared with HTN group values (−18.4 ± 3.0%, p = 0.031) and with HFpEF group values (−17.6 ± 2.3%, p < 0.001). The correlation between GLS values and HTN stages was significant, direct, and average (Spearman coefficient rho = 0.423, p < 0.001). GLS had the greatest ability to detect patients with HFpEF when HFpEF + CAD + HTN diastolic dysfunction (n = 30) + CON diastolic dysfunction (n = 2) from HFpEF + CAD + HTN + CON was analyzed. (optimal GLS limit of −19.35%, area under curve = 0.833, p < 0.001). Conclusions: Global longitudinal strain can be used for clinical assessment in differentiating coronary and hypertensive patients at higher risk for development of systolic dysfunction. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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12 pages, 691 KiB  
Article
Assessment of the Relationship between Mortality and Troponin I Levels in Hospitalized Patients with the Novel Coronavirus (COVID-19)
by Sinem Özyılmaz, Esra Ergün Alış, Emrah Ermiş, Samir Allahverdiyev and Hakan Uçar
Medicina 2020, 56(12), 693; https://doi.org/10.3390/medicina56120693 - 13 Dec 2020
Cited by 11 | Viewed by 2536
Abstract
Background and Objectives: This study aimed to evaluate the relationship between mortality and cardiac laboratory findings in patients who were hospitalized after a positive PCR for COVID-19 infection. Materials and Methods: This study included patients who were admitted to or referred [...] Read more.
Background and Objectives: This study aimed to evaluate the relationship between mortality and cardiac laboratory findings in patients who were hospitalized after a positive PCR for COVID-19 infection. Materials and Methods: This study included patients who were admitted to or referred to the hospital between 20 March and 20 June 2020, diagnosed with COVID-19 via a positive RT-PCR from nasal and pharyngeal swab samples. The troponin I level was measured from each patient. Medical records of patients were retrospectively reviewed and analyzed. Results: A hundred and five patients who were diagnosed with COVID-19 and hospitalized, or who died in the hospital due to COVID-19, were included in this study. There was a statistically significant difference between the troponin I high and low level groups in terms of age (years), BMI, shortness of breath (SB), oxygen saturation (%), hypertension, length of stay in the ICU; and for mortality, C-reactive protein, the neutrophil-to-lymphocyte ratio, hemoglobin, lactate dehydrogenase, ferritin, D-dimer, creatine kinase-MB, prothrombin time, calcium, and 25-hydroxy vitamin 25(OH)D3 (all p < 0.05). In the logistic analyses, a significant association was noted between troponin I and the adjusted risk of mortality. A ROC curve analysis identified troponin I values > 7.8 pg/mL as an effective cut-off point in mortality for patients with COVID-19. A troponin I value of higher than 7.8 pg/mL yielded a sensitivity of 78% and a specificity of 86%. Conclusions: The hospital mortality rate was higher among patients diagnosed with COVID-19 accompanied by troponin levels higher than 7.8 pg/mL. Therefore, in patients diagnosed with COVID-19, elevated troponin I levels >7.8 pg/mL can be considered an independent risk factor for mortality. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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Review

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9 pages, 654 KiB  
Review
Stress-Induced Cardiomyopathy—Considerations for Diagnosis and Management during the COVID-19 Pandemic
by Gassan Moady and Shaul Atar
Medicina 2022, 58(2), 192; https://doi.org/10.3390/medicina58020192 - 27 Jan 2022
Cited by 8 | Viewed by 3658
Abstract
The novel coronavirus disease 2019 (COVID-19) is associated with several cardiovascular manifestations including myocardial injury, myocarditis, arrhythmia, and pulmonary embolism. Rare cases of stress-induced cardiomyopathy, or takotsubo syndrome have also been reported during the acute infection, and secondary to stress following lockdown and [...] Read more.
The novel coronavirus disease 2019 (COVID-19) is associated with several cardiovascular manifestations including myocardial injury, myocarditis, arrhythmia, and pulmonary embolism. Rare cases of stress-induced cardiomyopathy, or takotsubo syndrome have also been reported during the acute infection, and secondary to stress following lockdown and self-isolation. Diagnosis in the setting of the acute infection is challenging since conventional imaging modalities such as transthoracic echocardiography and coronary angiography should be restricted to minimize physician-patient contact until the patients is tested negative for COVID-19. The use of point of care hand-held ultrasound is appropriate for this purpose. The overall course of the disease seems to be similar to takotsubo in the general population. Physicians should be familiar with the clinical presentation, possible complications, and management of takotsubo during COVID-19 outbreak. Here, we review the special considerations in the diagnosis and management of takotsubo syndrome during the current pandemic. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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6 pages, 536 KiB  
Review
Management of Patients with Left Ventricular Assist Device during the COVID-19 Pandemic
by Gassan Moady, Tuvia Ben Gal and Shaul Atar
Medicina 2022, 58(1), 116; https://doi.org/10.3390/medicina58010116 - 13 Jan 2022
Cited by 1 | Viewed by 2608
Abstract
The novel coronavirus disease 2019 (COVID-19) is an infectious disease with multi-organ involvement, including the cardiovascular system. The disease may cause several cardiovascular complications, and may increase morbidity and mortality among patients with background cardiovascular disease. Patients with advanced heart failure are often [...] Read more.
The novel coronavirus disease 2019 (COVID-19) is an infectious disease with multi-organ involvement, including the cardiovascular system. The disease may cause several cardiovascular complications, and may increase morbidity and mortality among patients with background cardiovascular disease. Patients with advanced heart failure are often treated with left ventricular assist device (LVAD), and represent a unique population mandating multi-disciplinary approach. Several aspects of COVID-19 should be taken into account in LVAD implants, including right ventricular involvement, hemodynamic alterations, thromboembolic and haemorrhagic complications, and the psychological effects of social isolation. Patients with VAD and suspected COVID-19 should be transferred to specialized centers for better management of complications. Here, we review the implications of COVID-19 pandemic on LVAD patients with our recommendations for appropriate management. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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10 pages, 410 KiB  
Review
Update on COVID-19 Myocarditis
by Arianne Clare C. Agdamag, Jonathan B. Edmiston, Victoria Charpentier, Mohammed Chowdhury, Meg Fraser, Valmiki R. Maharaj, Gary S. Francis and Tamas Alexy
Medicina 2020, 56(12), 678; https://doi.org/10.3390/medicina56120678 - 9 Dec 2020
Cited by 40 | Viewed by 8456
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) gained worldwide attention at the end of 2019 when it was identified to cause severe respiratory distress syndrome. While it primarily affects the respiratory system, we now have evidence that it affects multiple organ systems in [...] Read more.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) gained worldwide attention at the end of 2019 when it was identified to cause severe respiratory distress syndrome. While it primarily affects the respiratory system, we now have evidence that it affects multiple organ systems in the human body. Cardiac manifestations may include myocarditis, life threatening arrhythmias, acute coronary syndrome, systolic heart failure, and cardiogenic shock. Myocarditis is increasingly recognized as a complication of Coronavirus-19 (COVID-19) and may result from direct viral injury or from exaggerated host immune response. The diagnosis is established similar to other etiologies, and is based on detailed history, clinical exam, laboratory findings and non-invasive imaging studies. When available, cardiac MRI is the preferred imaging modality. Endomyocardial biopsy may be performed if the diagnosis remains uncertain. Current management is mainly supportive with the potential addition of interventions recommended for severe COVID-19 disease, such as remdesivir, steroids, and convalescent plasma. In the setting of cardiogenic shock and refractory, life-threatening arrhythmias that persist despite medical therapy, advanced mechanical circulatory support devices should be considered. Ultimately, early recognition and aggressive intervention are key factors in reducing morbidity and mortality. Our management strategy is expected to evolve further as we learn more about COVID-19 disease and the associated cardiac complications. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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Other

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5 pages, 2464 KiB  
Case Report
Cardiovascular Disorder after Cardiotoxic Non-Hodking’s Lymphoma Treatment: A Case Report
by Diana Žaliaduonytė, Rita Kleinauskienė, Gintarė Muckienė and Vytautas Zabiela
Medicina 2022, 58(4), 489; https://doi.org/10.3390/medicina58040489 - 29 Mar 2022
Cited by 1 | Viewed by 2904
Abstract
The non-Hodgkin’s lymphomas are a diverse group of lymphoid neoplasms that collectively rank fifth in cancer incidence and mortality. Patients treated with mediastinal radiotherapy and/or anthracycline-containing chemotherapy are known to have increased risks of coronary heart disease, valvular heart disease, and heart failure. [...] Read more.
The non-Hodgkin’s lymphomas are a diverse group of lymphoid neoplasms that collectively rank fifth in cancer incidence and mortality. Patients treated with mediastinal radiotherapy and/or anthracycline-containing chemotherapy are known to have increased risks of coronary heart disease, valvular heart disease, and heart failure. This may be the result of cancer treatment cardiotoxicity or may be due to accelerated development of cardiovascular disease. We presented 41-year-old male who was admitted to the hospital because of congestive heart failure. He has a medical history of non-Hodgkin’s lymphoma treated with anthracycline-based chemotherapy and mediastinal radiotherapy almost 20 years ago. Echocardiography showed significant aortic valve stenosis, thickened and fibrotic pericardium. Coronary angiography showed diffuse three-vessel coronary artery disease. The patient was referred for surgical treatment. Aortic valve replacement, coronary artery bypass grafting and pericardiectomy were successfully performed, symptoms of heart failure reduced. Full article
(This article belongs to the Special Issue Heart Failure in the Era of COVID 19)
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