Considerations on the rational use of beta receptor blockers in patients with Corona Virus Disease 2019 and cardiovascular disease
Wang Yuan1, Bi Xuefei1, Wang Zhiyun2, Wei Shoudong1, Deng Yongzhi3
1Department of Cardiology, 2Department of Neurology, 3Department of Cardiovascular Surgery, Shanxi Cardiovascular Hospital (Institute), the Affiliated Hospital of Shanxi Medical University and Shanxi Clinical Medical Research Center for Cardiovascular Disease, Taiyuan 030024，China
Abstract：The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the host cell through spike protein (S protein) binding with angiotensin-converting enzyme 2 (ACE2) of type Ⅱ alveolar epithelial cells, consuming large amounts of ACE2, resulting in the imbalance of the renin-angiotensin system (RAS). Excessive angiotensin Ⅱ (Ang Ⅱ) acts on angiotensin receptor 1 (AT1R), promoting pulmonary inflammatory infiltration, pulmonary fibrosis, increasing pulmonary capillary permeability, and then causes pulmonary injury. Once the lung impaired, it would in return further deteriorate the cardiovascular conditions, and even deprive the life of cardiovascular patients. As one of the first-line prescribed medications for cardiovascular patients, β receptor blockers could lower the total mortality rate of cardiovascular patients by antagonizing the activation of sympathetic nervous system and deactivating the activity of RAS system, playing the critical role to slow down heart rate, reduce myocardial oxygen consumption, lower blood pressure and reduce malignant arrhythmias. However, β receptor blockers could selectively inhibit the β2 receptor on bronchial smooth muscle and induce or aggravate bronchospasm, which may further deteriorate pulmonary in cardiovascular patients with Corona Vinus Disease （COVID-19）. Based on the mechanisms of β receptor blockers and their crucial roles in cardiopulmonary and vascular diseases, this paper illuminates the paradoxical scenarios of β receptor blockers application in patients with COVID-19 and cardiovascular disease during the epidemic.
王元 毕雪斐 王智云 魏首栋 邓勇志. 心血管病合并新型冠状病毒肺炎患者合理应用β受体阻滞剂的思考[J]. 中华诊断学电子杂志, 2020, 8(3): 203-207.
Wang Yuan1, Bi Xuefei1, Wang Zhiyun2, Wei Shoudong1, Deng Yongzhi3. Considerations on the rational use of beta receptor blockers in patients with Corona Virus Disease 2019 and cardiovascular disease. zhzdx, 2020, 8(3): 203-207.
