Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults
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 a...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032143 |
| _version_ | 1826988174231994368 |
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| author | Giulia La Vecchia Marco Giuseppe Del Buono Aldo Bonaventura Alessandra Vecchiè Francesco Moroni Iside Cartella Gianluigi Saponara Michael J. Campbell Lorenzo Dagna Enrico Ammirati Tommaso Sanna Antonio Abbate |
| author_facet | Giulia La Vecchia Marco Giuseppe Del Buono Aldo Bonaventura Alessandra Vecchiè Francesco Moroni Iside Cartella Gianluigi Saponara Michael J. Campbell Lorenzo Dagna Enrico Ammirati Tommaso Sanna Antonio Abbate |
| author_sort | Giulia La Vecchia |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-07T23:32:57Z |
| format | Article |
| id | doaj.art-bfc8f20fef6c44a8b7aec7ce056dba7c |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2025-02-18T07:48:35Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-bfc8f20fef6c44a8b7aec7ce056dba7c2024-11-05T14:15:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113410.1161/JAHA.123.032143Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in AdultsGiulia La Vecchia0Marco Giuseppe Del Buono1Aldo Bonaventura2Alessandra Vecchiè3Francesco Moroni4Iside Cartella5Gianluigi Saponara6Michael J. Campbell7Lorenzo Dagna8Enrico Ammirati9Tommaso Sanna10Antonio Abbate11Department of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome ItalyDepartment of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome ItalyS.C. Medicina Generale 1 Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette Laghi Varese ItalyS.C. Medicina Generale 1 Medical Center, Ospedale di Circolo e Fondazione Macchi, Department of Internal Medicine, ASST Sette Laghi Varese ItalyRobert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular Center University of Virginia Charlottesville Virginia USADepartment of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda Milan ItalyDepartment of Cardiovascular Medicine Fondazione Policlinico Universitario A. Gemelli IRCCS Rome ItalyDivision of Pediatric Cardiology, Department of Pediatrics Duke University Medical Center 2301 Erwin Road, DUMC Box 3127 Durham NC USAUnit of Immunology, Rheumatology, Allergy and Rare Diseases IRCCS San Raffaele Hospital, Vita‐Salute San Raffaele University Milan ItalyDepartment of Cardiology, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda Milan ItalyDepartment of Cardiovascular and Pulmonary Sciences Catholic University of the Sacred Heart Rome ItalyRobert M. Berne Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of Medicine, Heart and Vascular Center University of Virginia Charlottesville Virginia USAMultisystemic 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.https://www.ahajournals.org/doi/10.1161/JAHA.123.032143cardiogenic shockCOVID‐19cytokine stormheart failureinflammationmultisystemic inflammatory syndrome in adults |
| spellingShingle | Giulia La Vecchia Marco Giuseppe Del Buono Aldo Bonaventura Alessandra Vecchiè Francesco Moroni Iside Cartella Gianluigi Saponara Michael J. Campbell Lorenzo Dagna Enrico Ammirati Tommaso Sanna Antonio Abbate Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiogenic shock COVID‐19 cytokine storm heart failure inflammation multisystemic inflammatory syndrome in adults |
| title | Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults |
| title_full | Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults |
| title_fullStr | Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults |
| title_full_unstemmed | Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults |
| title_short | Cardiac Involvement in Patients With Multisystem Inflammatory Syndrome in Adults |
| title_sort | cardiac involvement in patients with multisystem inflammatory syndrome in adults |
| topic | cardiogenic shock COVID‐19 cytokine storm heart failure inflammation multisystemic inflammatory syndrome in adults |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032143 |
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