Volume 45, Issue 2 pp. 117-125
Original Article

Transient cardiac injury during H7N9 infection

Jie Han

Jie Han

Department of Cardiovascular Sciences, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Yun Mou

Yun Mou

Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Dong Yan

Dong Yan

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China

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Yun-Tao Zhang

Yun-Tao Zhang

Department of Intensive Care Unit, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Tian-An Jiang

Tian-An Jiang

Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Yuan-Yuan Zhang

Yuan-Yuan Zhang

Department of Cardiovascular Sciences, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Yi-Jiang Zhou

Yi-Jiang Zhou

Department of Cardiovascular Sciences, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Ze-Wei Sun

Ze-Wei Sun

Department of Cardiovascular Sciences, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Dong-Mei Jiang

Dong-Mei Jiang

Department of Cardiology, Biomedical Research (therapy) center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China

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Yan Chen

Yan Chen

Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

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Wei-Feng Liang

Corresponding Author

Wei-Feng Liang

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China

Correspondence to: Dr Wei-Feng Liang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. Tel.: 86-571-87236458; fax: 86-571-87236459; e-mail: [email protected]

Or

Dr Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. Tel.: 86-571-87236458; fax: 86-571-87236459; e-mail: [email protected]

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Lan-Juan Li

Corresponding Author

Lan-Juan Li

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China

Correspondence to: Dr Wei-Feng Liang, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. Tel.: 86-571-87236458; fax: 86-571-87236459; e-mail: [email protected]

Or

Dr Lan-Juan Li, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China. Tel.: 86-571-87236458; fax: 86-571-87236459; e-mail: [email protected]

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First published: 27 November 2014
Citations: 15

Abstract

Background

Recent reports have characterized virological and clinical features of the novel reassortant avian-origin influenza A (H7N9) virus. However, cardiovascular involvement during H7N9 infection is still unclear. In this study, we evaluate cardiac injury among H7N9-infected patients.

Materials and Methods

A total of 40 patients who were laboratory-confirmed with H7N9 infection were retrospectively included and grouped by Acute Physiology and Chronic Health Evaluation II (APACHE II) score into four subgroups I(0–10), II(11-20), III(21-30) and IV(31-71). Cardiovascular complications and markers of cardiac injury including creatinine kinase (CK), CK iso-enzyme (CK-MB), cardiac troponin I (cTNI) and brain natriuretic peptide (BNP) were assessed. Electrocardiogram (ECG) and echocardiography (ECHO) were also performed.

Results

Half of patients manifested with cardiovascular complications, with hypotension (47·5%) and heart failure (40·0%) the most prevalent. CK, CK-MB and cTNI showed marked increase with H7N9 virus infection but significantly decreased after H7N9 viral tests turned negative. More than half of patients presented with an abnormal ECG, but most of them are benign changes. ECHO examination showed different degree of impairment of cardiac function. Pulmonary artery systolic pressure was increased in all groups. Cardiac damage was more evident in patients with higher APACHE II score.

Conclusions

H7N9 virus exerts a transient impairment on the cardiovascular system. Patients with a higher APACHE II score are more susceptible to cardiac damage.

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