tetano
Editor, Senior Moderator
Braz J Infect Dis. 2016 Nov 29. pii: S1413-8670(16)30550-5. doi: 10.1016/j.bjid.2016.10.005. [Epub ahead of print]
[h=1]Cardiac complications associated with the influenza viruses A subtype H7N9 or pandemic H1N1 in critically ill patients under intensive care.[/h] Wang J[SUP]1[/SUP], Xu H[SUP]1[/SUP], Yang X[SUP]1[/SUP], Zhao D[SUP]1[/SUP], Liu S[SUP]1[/SUP], Sun X[SUP]1[/SUP], Huang JA[SUP]1[/SUP], Guo Q[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND AND OBJECTIVE:[/h] The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain.
[h=4]METHODS:[/h] Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention. Comparisons were conducted at the individual-level data of critically ill patients hospitalized with H7N9 (n=24) or pH1N1 (n=22) infections in Suzhou, China. Changes in cardiac biochemical markers, echocardiography, and electrocardiography during hospitalization in the intensive care unit were considered signs of cardiac complications.
[h=4]RESULTS:[/h] The following findings were more common among the H7N9 group relative to the pH1N1 group: greater tricuspid regurgitation pressure gradient, sinus tachycardia (heartbeat≥130bpm), ST segment depression, right ventricular dysfunction, and elevated cardiac biochemical markers. Pericardial effusion was more often found among pH1N1 patients than in the H7N9 group. In both groups, most of the cardiac complications were detected from day 6 to 14 after the onset of influenza symptoms. Those who developed cardiac complications were especially vulnerable during the first four days after initiation of mechanical ventilation. Cardiac complications were reversible in the vast majority of discharged H7N9 patients.
[h=4]CONCLUSIONS:[/h] Critically ill hospitalized H7N9 patients experienced a higher rate of cardiac complications than did patients with 2009 pH1N1 infections, with the exception of pericardial effusion. This study may help in the prevention, identification, and treatment of influenza-induced cardiac complications in both pH1N1 and H7N9 infections.
Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.
[h=4]KEYWORDS:[/h] Cardiac complications; H1N1; H7N9
PMID: 27912070 DOI: 10.1016/j.bjid.2016.10.005
[PubMed - as supplied by publisher] Free full text
[h=1]Cardiac complications associated with the influenza viruses A subtype H7N9 or pandemic H1N1 in critically ill patients under intensive care.[/h] Wang J[SUP]1[/SUP], Xu H[SUP]1[/SUP], Yang X[SUP]1[/SUP], Zhao D[SUP]1[/SUP], Liu S[SUP]1[/SUP], Sun X[SUP]1[/SUP], Huang JA[SUP]1[/SUP], Guo Q[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND AND OBJECTIVE:[/h] The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain.
[h=4]METHODS:[/h] Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention. Comparisons were conducted at the individual-level data of critically ill patients hospitalized with H7N9 (n=24) or pH1N1 (n=22) infections in Suzhou, China. Changes in cardiac biochemical markers, echocardiography, and electrocardiography during hospitalization in the intensive care unit were considered signs of cardiac complications.
[h=4]RESULTS:[/h] The following findings were more common among the H7N9 group relative to the pH1N1 group: greater tricuspid regurgitation pressure gradient, sinus tachycardia (heartbeat≥130bpm), ST segment depression, right ventricular dysfunction, and elevated cardiac biochemical markers. Pericardial effusion was more often found among pH1N1 patients than in the H7N9 group. In both groups, most of the cardiac complications were detected from day 6 to 14 after the onset of influenza symptoms. Those who developed cardiac complications were especially vulnerable during the first four days after initiation of mechanical ventilation. Cardiac complications were reversible in the vast majority of discharged H7N9 patients.
[h=4]CONCLUSIONS:[/h] Critically ill hospitalized H7N9 patients experienced a higher rate of cardiac complications than did patients with 2009 pH1N1 infections, with the exception of pericardial effusion. This study may help in the prevention, identification, and treatment of influenza-induced cardiac complications in both pH1N1 and H7N9 infections.
Copyright © 2016 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.
[h=4]KEYWORDS:[/h] Cardiac complications; H1N1; H7N9
PMID: 27912070 DOI: 10.1016/j.bjid.2016.10.005
[PubMed - as supplied by publisher] Free full text