COVID-19 and cardiovascular disease: what have we learned?

Viewpoint
Tessitore E, Meyer P
Swiss Med Wkly. 2020;150:w20452

As of 10 December, 82,127 citations were found in PubMed on COVID-19 and 5285 when “COVID-19 and cardiovascular disease” were used as search words. Many cardiovascular societies have also released statements regarding COVID-19. What have we learned from this incredible scientific excitement?

Impact of the COVID-19 pandemic on acute coronary syndromes

Original article
Perrin N, Iglesias JF, Rey F, Benzakour L, Cimci M, Noble S, Degrauwe S, Tessitore E, Mach F, Roffi M
Swiss Med Wkly. 2020;150:w20448

Prolonged delays from symptom onset to first medical contact and a decline in overall ACS incidence were observed during the first wave of the COVID-19 pandemic, with a higher threshold to call for help among ACS patients.

Cardiovascular aspects of COVID-19

Review article: Biomedical intelligence
Eberli FR, Kurz D
Swiss Med Wkly. 2020;150:w20417

In this review, findings and debates relating to the diverse aspects of cardiovascular involvement of COVID-19 are summarised and put into perspective. The authors review evidence for the role of the renin-angiotensin-aldosterone system (RAAS), the risk of pre-existing cardiovascular disease in COVID-19 susceptibility and course, and the mechanism of acute and long-term myocardial injury.

The renin-angiotensin-aldosterone system inhibitors in COVID-19: from acidosis to ventilation and immunity

Viewpoint
Liao WH, Yang GG, Henneberg M
Swiss Med Wkly. 2020;150:w20444

The authors explain mechanisms by which inhibitors of the renin-angiotensin-aldosterone system may increase susceptibility to and the development of cytokine storm during SARS-CoV-2 infection.

Expert recommendation from the Swiss Amyloidosis Network (SAN) for systemic AL-amyloidosis

Review article: Medical guidelines
Schwotzer R, Flammer AJ, Gerull S, Pabst T, Arosio P, Averaimo M, Bacher VU, Bode P, Cavalli A, Concoluci A, Dirnhofer S, Djerbi N, Dobner SW, Fehr T, Garofalo M, Gaspert A, Heimgartner R, Hübers A, Jung HH, Kessler C, Knöpfel R, Laptseva N, Manka R, Mazzucchelli L, Meyer M, Mihaylova V, Monney P, Mylonas A, Nkoulou R, Pazhenkottil A, Pfister O, Rüfer A, Schmidt A, Seeger H, Stämpfli SF, Stirnimann G, Suter T, Théaudin M, Treglia G, Tzankov A, Vetter F, Zweier M, Gerber B
Swiss Med Wkly. 2020;150:w20364

These are the Swiss Amyloidosis Network recommendations which focus on diagnostic work-up and treatment of AL-amyloidosis. One aim of this meeting was to establish a consensus guideline regarding the diagnostic work-up and the treatment recommendations for systemic amyloidosis tailored to the Swiss health care system.

Impact of first medical contact to revascularisation time on long-term clinical outcomes in ST-segment elevation myocardial infarction patients

Original article
Roux O, Schweighauser A, Schukraft S, Stauffer JC, Goy JJ, Wenaweser P, Togni M, Windecker S, Cook S, Arroyo D, Puricel S
Swiss Med Wkly. 2020;150:w20368

The prescription retroscope – tools for advocating critical and individualised therapy

Viewpoint
Cook S, Messerli FH
Swiss Med Wkly. 2020;150:w20342

Should we give beta-blockers to all patients after myocardial infarction? Beta-blockers have been clearly shown decrease mortality after myocardial infarction, but this was documented more than a quarter of a century ago, before the current revascularisation era, and has become uncertain at the present. Nowadays, the only ironclad indication for cardioprotection with beta-blockers remains heart failure with reduced ejection fraction, the very indication that half a century ago was the only contraindication for beta-blocker therapy.

Patiromer and medication optimisation in heart failure with reduced ejection fraction: a Swiss perspective

Review article: Biomedical intelligence
Meyer P, Lu H, Hullin R
Swiss Med Wkly. 2020;150:w20362

Despite medical advances, heart failure remains a major public health issue and is associated with considerable morbidity and mortality. Suboptimal use of evidence-based therapies and lack of medication up-titration play important roles in this regard. Hyperkalaemia is a frequent and potentially harmful finding which hinders treatment optimisation in patients with heart failure. In this review, heart failure experts from two Swiss academic hospitals discuss the principles of general pharmacological therapy in heart failure with reduced ejection fraction and the different treatment options for chronic hyperkalaemia, focusing on patiromer, a recently available potassium binder. 

Use of the wearable cardioverter-defibrillator – the Swiss experience

Original article
Kovacs B, Reek S, Sticherling C, Schaer B, Linka A, Ammann P, Brenner R, Krasniqi N, Müller AS, Dzemali O, Kobza R, Grebmer C, Haegeli L, Berg J, Mayer K, Schläpfer J, Domenichini G, Reichlin T, Roten L, Burri H, Eriksson U, Saguner AM, Steffel J, Duru F, Swiss WCD Registry
Swiss Med Wkly. 2020;150:w20343

The use of wearable cardioverter defibrillators has increased in Switzerland over the years for a variety of indications. There is high therapy adherence to the WCD, and a treatment rate comparable to previously published registry data.

Choir singing improves respiratory muscle strength and quality of life in patients with structural heart disease – HeartChoir: a randomised clinical trial

Original article
Ganzoni C, Arslani K, Pfister O, Freese M, Strobel W, Mueller C, Tobler D
Swiss Med Wkly. 2020;150:w20346

Choir singing in combination with respiratory muscle training improved respiratory muscle strength and quality of life in patients with structural heart disease and may therefore be valuable supplements in cardiac rehabilitation.