COVID-19 : A double threat to takotsubo cardiomyopathy and spontaneous coronary artery dissection?
Copyright © 2020 Elsevier Ltd. All rights reserved..
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has affected millions of individuals worldwide. Prior studies suggest that COVID-19 may be associated with an increased risk for various cardiovascular disorders, such as myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. Early reports of non-COVID-19 patients have described the concurrence of takotsubo cardiomyopathy (TTC) and spontaneous coronary artery dissection (SCAD). However, the interplay between COVID-19, TTC and SCAD has not been well established. We herein propose two sets of two-hit hypotheses for the development of SCAD and TTC in the context of COVID-19. The first two-hit hypothesis explains the development of SCAD, in which TTC-associated formation of vulnerable coronary substrate serves as the first hit (predisposing factor), and COVID-19-associated inflammation and vascular disruption serves as the second hit (precipitating factor). The second two-hit hypothesis is proposed to explain the development of TTC, in which SCAD-associated formation of vulnerable myocardial substrate serves as the first hit, and COVID-19-associated sympathetic overactivity serves as the second hit. Under this conceptual framework, COVID-19 poses a double threat for the development of SCAD (among patients with underlying TTC) as well as TTC (among patients with underlying SCAD), thereby forming a reciprocal causation. This hypothesis provides a rationale for the joint assessment of TTC and SCAD in COVID-19 patients with pertinent cardiovascular manifestations.
| Errataetall: |
CommentIn: Med Hypotheses. 2021 Jan;146:110471. - PMID 33387939 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:146 |
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| Enthalten in: |
Medical hypotheses - 146(2021) vom: 20. Jan., Seite 110410 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shojaei, Fahimehalsadat [VerfasserIn] |
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| Links: |
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| Themen: |
Acute coronary syndrome |
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| Anmerkungen: |
Date Completed 01.02.2021 Date Revised 13.04.2023 published: Print-Electronic CommentIn: Med Hypotheses. 2021 Jan;146:110471. - PMID 33387939 Citation Status MEDLINE |
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| doi: |
10.1016/j.mehy.2020.110410 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM318341808 |
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| 520 | |a Copyright © 2020 Elsevier Ltd. All rights reserved. | ||
| 520 | |a Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has affected millions of individuals worldwide. Prior studies suggest that COVID-19 may be associated with an increased risk for various cardiovascular disorders, such as myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. Early reports of non-COVID-19 patients have described the concurrence of takotsubo cardiomyopathy (TTC) and spontaneous coronary artery dissection (SCAD). However, the interplay between COVID-19, TTC and SCAD has not been well established. We herein propose two sets of two-hit hypotheses for the development of SCAD and TTC in the context of COVID-19. The first two-hit hypothesis explains the development of SCAD, in which TTC-associated formation of vulnerable coronary substrate serves as the first hit (predisposing factor), and COVID-19-associated inflammation and vascular disruption serves as the second hit (precipitating factor). The second two-hit hypothesis is proposed to explain the development of TTC, in which SCAD-associated formation of vulnerable myocardial substrate serves as the first hit, and COVID-19-associated sympathetic overactivity serves as the second hit. Under this conceptual framework, COVID-19 poses a double threat for the development of SCAD (among patients with underlying TTC) as well as TTC (among patients with underlying SCAD), thereby forming a reciprocal causation. This hypothesis provides a rationale for the joint assessment of TTC and SCAD in COVID-19 patients with pertinent cardiovascular manifestations | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Acute coronary syndrome | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Spontaneous coronary artery dissection | |
| 650 | 4 | |a Stress cardiomyopathy | |
| 650 | 4 | |a Takotsubo cardiomyopathy | |
| 700 | 1 | |a Habibi, Zahra |e verfasserin |4 aut | |
| 700 | 1 | |a Goudarzi, Sogand |e verfasserin |4 aut | |
| 700 | 1 | |a Firouzabadi, Fatemeh Dehghani |e verfasserin |4 aut | |
| 700 | 1 | |a Montazerin, Sahar Memar |e verfasserin |4 aut | |
| 700 | 1 | |a Najafi, Homa |e verfasserin |4 aut | |
| 700 | 1 | |a Kahe, Farima |e verfasserin |4 aut | |
| 700 | 1 | |a Momenzadeh, Kaveh |e verfasserin |4 aut | |
| 700 | 1 | |a Mir, Mahshid |e verfasserin |4 aut | |
| 700 | 1 | |a Khan, Faris |e verfasserin |4 aut | |
| 700 | 1 | |a Jamil, Umer |e verfasserin |4 aut | |
| 700 | 1 | |a Jamil, Adeel |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Jane J |e verfasserin |4 aut | |
| 700 | 1 | |a Chi, Gerald |e verfasserin |4 aut | |
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