학술논문
Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults.
Document Type
Academic Journal
Author
La Vecchia G; Department of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome Italy.; Center of Excellence in Cardiovascular Sciences Isola Tiberina Hospital Gemelli Isola Rome Italy.; Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy.; Del Buono MG; Department of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome Italy.; Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy.; Bonaventura A; S.C. Medicina Generale 1 Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette Laghi Varese Italy.; Vecchiè A; S.C. Medicina Generale 1 Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette Laghi Varese Italy.; Moroni F; Robert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular Center University of Virginia Charlottesville Virginia USA.; Cartella I; Department of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda Milan Italy.; Saponara G; Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy.; Campbell MJ; Division of Pediatric Cardiology, Department of Pediatrics Duke University Medical Center 2301 Erwin Road, DUMC Box 3127 Durham NC USA.; Dagna L; Unit of Immunology, Rheumatology, Allergy and Rare Diseases IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University Milan Italy.; Ammirati E; Department of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda Milan Italy.; Sanna T; Department of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome Italy.; Department of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy.; Abbate A; Robert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular Center University of Virginia Charlottesville Virginia USA.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
Subject
Language
English
Abstract
Multisystemic inflammatory syndrome in adults is a hyperinflammatory condition following (within 4-12 weeks) SARS-CoV-2 infection. Here, the dysregulation of the immune system leads to a multiorgan involvement often affecting the heart. Cardiac involvement in multisystemic inflammatory syndrome in adults has been described mainly in young men without other comorbidities and may present with different clinical scenarios, including acute heart failure, life-threatening arrhythmias, pericarditis, and myocarditis, with a nonnegligible risk of mortality (up to 7% of all cases). The heterogeneity of its clinical features and the absence of a clear case definition make the differential diagnosis with other postinfectious (eg, infective myocarditis) and hyperinflammatory diseases (eg, adult Still disease and macrophage activation syndrome) challenging. Moreover, the evidence on the efficacy of specific treatments targeting the hyperinflammatory response underlying this clinical condition (eg, glucocorticoids, immunoglobulins, and other immunomodulatory agents) is sparse and not supported by randomized clinical trials. In this review article, we aim to provide an overview of the clinical features and the diagnostic workup of multisystemic inflammatory syndrome in adults with cardiac involvement, highlighting the possible pathogenetic mechanisms and the therapeutic management, along with remaining knowledge gaps in this field.