Since early in pandemic, COVID-19 has been linked to heart problems, including reduced ability to pump blood and abnormal heart rhythms.
But it has been an open question whether it is these viruses that are causing the heart-borne virus, or an infectious response to a viral infection elsewhere in the body. Such details have an impact on understanding how best to treat coronavirus diseases that affect the heart.
A new study from the University of Washington School of Medicine in St. Louis provides evidence that COVID-19 patients’ heart damage is caused by the virus attacking and reproducing within heart muscle cells, leading to cell death and affecting shortening of heart muscles.
The researchers used stem cells to devise a heart-shaped contraction that modulates the human disease and may help in the study of the disease and develop possible therapies.
The study is published Feb. 26 in the Journal of the American College of Geology: Fundamentals to Translational Science.
“Early in the pandemic, we had evidence that this coronavirus can cause heart failure or heart injury in healthy individuals in general, which was frightening to the cardiology community,” said lead author Kory J. Lavine, MD, Ph.D., associate professor of medicine. “Even some college athletes who were abducted to return to competitive athletics after COVID-19 infection showed scarring in the heart. There has been debate as to whether this is due to a direct infection that heart or as a result of a systemic systemic response that occurs due to lung infection.
“Our study is unique because it conclusively shows that, in patients with COVID-19 who have developed heart failure, the virus affects the heart, particularly heart muscle cells.”
Lavine and colleagues -; including colleagues Michael S. Diamond, MD, Ph.D., Herbert S. Gasser Professor of Medicine, and Michael J. Greenberg, PhD, assistant professor of biochemistry and molecular biology -; also uses stem cells to create a mechanism that models how human heart contractions contract. Examining these models of cardiac tension, they concluded that viral disease not only kills heart muscle cells but destroys the muscle fiber units responsible for heart muscle contraction.
They also showed that this cell death and loss of heart muscle fiber can occur even without inflammation.
“Inflammation can be a second blow to the top of the damage caused by the virus, but the inflammation itself is not the first cause of the heart injury,” said Lavine.
Other viral infections have long been linked to heart damage, but Lavine said SARS-CoV-2, the virus that causes COVID-19, is unique in its effect on the heart. heart, especially in the immune cells that respond to the disease. In COVID-19, immune cells called macrophages, monocytes and dendritic cells control the immune response. For most other viruses that affect the heart, T cells and B cells of the immune system are on the horizon.
“COVID-19 triggers a different immune response in the heart compared to other viruses, and we don’t know what that means yet,” Lavine said. “In general, the immune cells seen respond. other viruses tend to be associated with relatively short-term infection that resolves with supportive care. But the immune cells we see in COVID-19 heart patients tend to be associated with a persistent condition that can have long-term effects. These are societies, so we need more research to understand what is happening. “
Part of the reason why these questions on the cause of heart damage has been difficult to answer is the difficulty of studying heart tension from COVID-19 patients. The researchers were able to confirm their results by examining print from four COVID-19 patients who had heart-related heart injuries, but more research is needed.
To that end, Lavine and Diamond, are working to develop a mouse model of the heart injury. To emphasize the speed of the operation, Lavine noted the severity of the heart damage that COVID-19 can cause.
Even young people with mild symptoms can later develop heart problems that limit their ability to exercise. We want to understand what is happening so that we can prevent or control it. In the meantime, we want everyone to take this virus seriously and do their best to take steps and stop its spread, so that we do not have a further epidemic of illness. a preventable heart in the future. “
Kory J. Lavine, MD, PhD, Lead Author Study and Associate Professor of Medicine, University of Washington School of Medicine
Source:
Washington University School of Medicine
Magazine Reference:
Bailey, AL, et al. (2021) SARS-CoV-2 affects heart fibers and human engineering models of COVID-19 Myocarditis. JACC: Basic in Translation Science. doi.org/10.1016/j.jacbts.2021.01.002.