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Sattar Y, Ullah W, Rauf H, Virk HUH, Yadav S, Chowdhury M, Connerney M, Mamtani S, Pahuja M, Patel RD, Mir T, Almas T, Moussa Pacha H, Chadi Alraies M. COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management. IJC HEART & VASCULATURE 2020; 29:100589. [PMID: 32724831 PMCID: PMC7359794 DOI: 10.1016/j.ijcha.2020.100589] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 02/08/2023]
Abstract
Coronavirus Disease 2019 (COVID-19) is a rapidly progressing global pandemic that may present with a variety of cardiac manifestations including, but not limited to, myocardial injury, myocardial infarction, arrhythmias, heart failure, cardiomyopathy, shock, thromboembolism, and cardiac arrest. These cardiovascular effects are worse in patients who have pre-existing cardiac conditions such as coronary artery disease, hypertension, diabetes mellitus, and coagulation abnormalities. Other predisposing risk factors include advanced age, immunocompromised state, and underlying systemic inflammatory conditions. Here we review the cellular pathophysiology, clinical manifestations and treatment modalities of the cardiac manifestations seen in patients with COVID-19.
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Affiliation(s)
- Yasar Sattar
- Internal Medicine, Icahn School of Medicine at Mount Sinai – Elmhurst Hospital, NY, USA
| | - Waqas Ullah
- Internal Medicine, Abington Jefferson Health, PA, USA
| | - Hiba Rauf
- Internal Medicine, American Society of Clinical Oncology, VA, USA
| | - Hafeez ul Hassan Virk
- Interventional Cardiology, Case Western Reserve University/University Hospitals, Cleveland Medical Center, Cleveland, OH, USA
| | - Sunita Yadav
- Internal Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY, USA
| | - Medhat Chowdhury
- Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Michael Connerney
- Internal Medicine, Icahn School of Medicine at Mount Sinai – Elmhurst Hospital, NY, USA
| | - Sahil Mamtani
- Internal Medicine, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY, USA
| | - Mohit Pahuja
- Internal Medicine, Rochester General Hospital, Rochester, NY, USA
- Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Raj D. Patel
- Detroit Medical Center, Wayne State University, Detroit, MI, USA
- University of Illinois College of Medicine Peoria, Chicago, IL, USA
| | - Tanveer Mir
- Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Talal Almas
- Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Homam Moussa Pacha
- Cardiology Department, University of Texas, Memorial Hermann Heart and Vascular Institute, Houston, TX, USA
| | - M. Chadi Alraies
- Detroit Medical Center, Wayne State University, Detroit, MI, USA
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Pierzchala K, Houdi AA, Van Loon GR. Nicotine-induced alterations in brain regional concentrations of native and cryptic Met- and Leu-enkephalin. Peptides 1987; 8:1035-43. [PMID: 3441443 DOI: 10.1016/0196-9781(87)90133-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The distribution of cryptic forms (larger enkephalin-containing peptides) in neostriatum, hypothalamus, spinal cord T3-L1 and neurointermediate lobe of pituitary were determined by radioimmunoassay. Optimal conditions for enzymic hydrolysis of the cryptic enkephalins by trypsin and carboxypeptidase B were established. The proportion of total Met- and Leu-enkephalin represented by native pentapeptide varied markedly among these central nervous system regions. Also, the distributions of native and cryptic Met-enkephalin were distinct from that of Leu-enkephalin. Chromatographic separation by HPLC of immunoreactive Met-enkephalin peptides revealed only two peaks corresponding to Met-enkephalin and Met-enkephalin sulfoxide in rather equal amounts. Hydrolysis of cryptic Met-enkephalin also produced only two HPLC-separable peaks of immunoreactive Met-enkephalin, again corresponding to Met-enkephalin and Met-enkephalin sulfoxide. Bioactivity of cryptic striatal Met-enkephalin after hydrolysis was demonstrated by antinociception and catalepsy in rats following its intracerebroventricular injection. Repeated short-term administration of nicotine, 0.1 mg/kg IP six times at 30 min intervals, produced significant increases in native and cryptic Met-enkephalin in striatum, consistent with an increase in neuronal release of Met-enkephalin together with increases in synthesis and processing of proenkephalin A in this brain region. This regimen of nicotine also decreased levels of native Met-enkephalin and of both native and cryptic Leu-enkephalin in neurointermediate lobe, consistent with nicotine-induced release of both proenkephalin A- and prodynorphin-derived peptides from neurointermediate lobe.
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