Cardiovascular complications in malaria: a review.
10.19540/j.cnki.cjcmm.20230510.707
- Author:
Yu LI
1
;
Zhong-Yuan ZHENG
2
;
Yu ZHANG
1
;
Shui-Qing QU
1
;
Shuo-Qiu DENG
1
;
Yue DAI
2
;
Cheng-Cheng LIU
1
;
Tuo LIU
2
;
Li-Na CHEN
2
;
Yu-Jie LI
1
Author Information
1. Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700,China.
2. Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700,China Artemisinin Research Center, China Academy of Chinese Medical Sciences Beijing 100700,China.
- Publication Type:Journal Article
- Keywords:
antimalarials;
artemisinins;
cardiovascular disease;
complication;
malaria
- MeSH:
Child;
Adult;
Humans;
Antimalarials/pharmacology*;
Cardiovascular Diseases/drug therapy*;
Artemisinins/pharmacology*;
Quinolines;
Malaria, Cerebral/drug therapy*;
Heart Failure/drug therapy*;
Arrhythmias, Cardiac/drug therapy*
- From:
China Journal of Chinese Materia Medica
2023;48(18):4902-4907
- CountryChina
- Language:Chinese
-
Abstract:
Malaria, one of the major global public health events, is a leading cause of mortality and morbidity among children and adults in tropical and subtropical regions(mainly in sub-Saharan Africa), threatening human health. It is well known that malaria can cause various complications including anemia, blackwater fever, cerebral malaria, and kidney damage. Conventionally, cardiac involvement has not been listed as a common reason affecting morbidity and mortality of malaria, which may be related to ignored cases or insufficient diagnosis. However, the serious clinical consequences such as acute coronary syndrome, heart failure, and malignant arrhythmia caused by malaria have aroused great concern. At present, antimalarials are commonly used for treating malaria in clinical practice. However, inappropriate medication can increase the risk of cardiovascular diseases and cause severe consequences. This review summarized the research advances in the cardiovascular complications including acute myocardial infarction, arrhythmia, hypertension, heart failure, and myocarditis in malaria. The possible mechanisms of cardiovascular diseases caused by malaria were systematically expounded from the hypotheses of cell adhesion, inflammation and cytokines, myocardial apoptosis induced by plasmodium toxin, cardiac injury secondary to acute renal failure, and thrombosis. Furthermore, the effects of quinolines, nucleoprotein synthesis inhibitors, and artemisinin and its derivatives on cardiac structure and function were summarized. Compared with the cardiac toxicity of quinolines in antimalarial therapy, the adverse effects of artemisinin-derived drugs on heart have not been reported in clinical studies. More importantly, the artemisinin-derived drugs demonstrate favorable application prospects in the prevention and treatment of cardiovascular diseases, and are expected to play a role in the treatment of malaria patients with cardiovascular diseases. This review provides reference for the prevention and treatment of malaria-related cardiovascular complications as well as the safe application of antimalarials.
