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Reasons for increased severe COVID-19 courses in heart disease
Among the severe COVID-19 courses that are triggered by the SARS-CoV-2 coronavirus, people with heart disease are particularly common. So far this relationship has only been observed. An American research team has now found the first reasons for this connection.
A research team from the renowned Mayo Clinic in the USA provides important information about the connection between heart disease and severe COVID-19 courses and why cardiac patients have an increased risk of serious disease courses. The study was published as a pre-proof in the Mayo Clinic Proceedings journal.
More ACE-2 receptors for certain heart conditions
Several evaluations have already shown that people with certain heart diseases are often found among the severe COVID-19 courses. The Mayo Clinic team has now found a possible explanation for this connection. The latest research indicates that in patients with obstructive hypertrophic cardiomyopathy, the production of ACE2 protein in the heart is increased. It is precisely this protein that SARS-CoV-2 needs to get into the cells.
Double negative effect
Normally, the heart tries to compensate for illness-related changes through the increased production. However, the increased number of ACE2 receptors also offers the virus more points of attack. According to the Mayo Clinic experts, this has two negative consequences. On the one hand, the virus can penetrate the cells more frequently and at the same time occupies a protective signaling pathway that normally counteracts the negative influence of the hormone angiotensin II. This hormone increases blood pressure and leads to fluid retention.
The researchers analyzed samples of cardiac muscle tissue from 106 patients who underwent surgery for obstructive hypertrophic cardiomyopathy (HCM). In addition, 39 healthy donor hearts were examined as a control group. "Of all RNA transcripts in the entire human genome, our research showed that the most highly regulated RNA transcript in the heart muscle was ACE2," summarizes cardiologist Dr. Michael Ackerman together.
Fivefold increase in ACE2 protein levels
"In fact, we confirmed a five-fold increase in ACE2 protein levels in the heart muscle in these patients with obstructive HCM," said the heart expert. This is a possible explanation for why COVID-19 sufferers with certain heart diseases are at a higher risk of severe courses.
Does this apply to all heart diseases?
So far, the effect has only been confirmed in obstructive hypertrophic cardiomyopathy. In the next step, the team plans to check this connection for other heart diseases such as high blood pressure. The researchers also suggest that ACE2 levels in the lung tissue of COIVD-19 deceased be checked to see if it is higher than in healthy individuals. (vb)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
- Mayo Clinic: Physicians, scientists and physician-scientists connect dots between heart disease, potential for worse COVID-19 outcomes (04/27/2020), newsnetwork.mayoclinic.org
- J. Martijn Bos, Virginia B. Hebl, Ann L. Oberg, et al .: Marked Up-Regulation of ACE2 in Hearts of Patients with Obstructive Hypertrophic Cardiomyopathy: Implications for SARS-CoV-2-Mediated COVID-19; in: Mayo Clinic Proceedings, 2020, mayoclinicproceedings.org