Coronary microvascular dysfunction is common in patients hospitalized with COVID-19 infection.
Microcirculation
; 29(4-5): e12757, 2022 07.
Article
in English
| MEDLINE | ID: covidwho-1794606
ABSTRACT
BACKGROUND AND AIMS:
Microvascular disease is considered as one of the main drivers of morbidity and mortality in severe COVID-19, and microvascular dysfunction has been demonstrated in the subcutaneous and sublingual tissues in COVID-19 patients. The presence of coronary microvascular dysfunction (CMD) has also been hypothesized, but direct evidence demonstrating CMD in COVID-19 patients is missing. In the present study, we aimed to investigate CMD in patients hospitalized with COVID-19, and to understand whether there is a relationship between biomarkers of myocardial injury, myocardial strain and inflammation and CMD.METHODS:
39 patients that were hospitalized with COVID-19 and 40 control subjects were included to the present study. Biomarkers for myocardial injury, myocardial strain, inflammation, and fibrin turnover were obtained at admission. A comprehensive echocardiographic examination, including measurement of coronary flow velocity reserve (CFVR), was done after the patient was stabilized.RESULTS:
Patients with COVID-19 infection had a significantly lower hyperemic coronary flow velocity, resulting in a significantly lower CFVR (2.0 ± 0.3 vs. 2.4 ± 0.5, p < .001). Patients with severe COVID-19 had a lower CFVR compared to those with moderate COVID-19 (1.8 ± 0.2 vs. 2.2 ± 0.2, p < .001) driven by a trend toward higher basal flow velocity. CFVR correlated with troponin (p = .003, r -.470), B-type natriuretic peptide (p < .001, r -.580), C-reactive protein (p < .001, r -.369), interleukin-6 (p < .001, r -.597), and d-dimer (p < .001, r -.561), with the three latter biomarkers having the highest areas-under-curve for predicting CMD.CONCLUSIONS:
Coronary microvascular dysfunction is common in patients with COVID-19 and is related to the severity of the infection. CMD may also explain the "cryptic" myocardial injury seen in patients with severe COVID-19 infection.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Myocardial Ischemia
/
COVID-19
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Microcirculation
Journal subject:
Vascular Diseases
Year:
2022
Document Type:
Article
Affiliation country:
Micc.12757
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