tetano
Editor, Senior Moderator
Eur Heart J Cardiovasc Imaging
. 2023 May 31;jead118.
doi: 10.1093/ehjci/jead118. Online ahead of print. Coronary microvascular health in symptomatic patients with prior COVID-19 infection: an updated analysis
Ahmed Ibrahim Ahmed[SUP] 1 [/SUP], Mahmoud Al Rifai[SUP] 1 [/SUP], Fares Alahdab[SUP] 1 [/SUP], Jean Michel Saad[SUP] 1 [/SUP], Yushui Han[SUP] 1 [/SUP], Moath Said Alfawara[SUP] 1 [/SUP], Malek Nayfeh[SUP] 1 [/SUP], Maan Malahfji[SUP] 1 [/SUP], Faisal Nabi[SUP] 1 [/SUP], John J Mahmarian[SUP] 1 [/SUP], John P Cooke[SUP] 1 [/SUP], William A Zoghbi[SUP] 1 [/SUP], Mouaz H Al-Mallah[SUP] 1 [/SUP]
Affiliations
Aims: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with endothelial dysfunction. We aimed to determine the effects of prior coronavirus disease 2019 (COVID-19) on the coronary microvasculature accounting for time from COVID-19, disease severity, SARS-CoV-2 variants, and in subgroups of patients with diabetes and those with no known coronary artery disease.
Methods and results: Cases consisted of patients with previous COVID-19 who had clinically indicated positron emission tomography (PET) imaging and were matched 1:3 on clinical and cardiovascular risk factors to controls having no prior infection. Myocardial flow reserve (MFR) was calculated as the ratio of stress to rest myocardial blood flow (MBF) in mL/min/g of the left ventricle. Comparisons between cases and controls were made for the odds and prevalence of impaired MFR (MFR < 2). We included 271 cases matched to 815 controls (mean ± SD age 65 ± 12 years, 52% men). The median (inter-quartile range) number of days between COVID-19 infection and PET imaging was 174 (58-338) days. Patients with prior COVID-19 had a statistically significant higher odds of MFR <2 (adjusted odds ratio 3.1, 95% confidence interval 2.8-4.25 P < 0.001). Results were similar in clinically meaningful subgroups. The proportion of cases with MFR <2 peaked 6-9 months from imaging with a statistically non-significant downtrend afterwards and was comparable across SARS-CoV-2 variants but increased with increasing severity of infection.
Conclusion: The prevalence of impaired MFR is similar by duration of time from infection up to 1 year and SARS-CoV-2 variants, but significantly differs by severity of infection.
Keywords: COVID; PET; coronary microvascular dysfunction.
. 2023 May 31;jead118.
doi: 10.1093/ehjci/jead118. Online ahead of print. Coronary microvascular health in symptomatic patients with prior COVID-19 infection: an updated analysis
Ahmed Ibrahim Ahmed[SUP] 1 [/SUP], Mahmoud Al Rifai[SUP] 1 [/SUP], Fares Alahdab[SUP] 1 [/SUP], Jean Michel Saad[SUP] 1 [/SUP], Yushui Han[SUP] 1 [/SUP], Moath Said Alfawara[SUP] 1 [/SUP], Malek Nayfeh[SUP] 1 [/SUP], Maan Malahfji[SUP] 1 [/SUP], Faisal Nabi[SUP] 1 [/SUP], John J Mahmarian[SUP] 1 [/SUP], John P Cooke[SUP] 1 [/SUP], William A Zoghbi[SUP] 1 [/SUP], Mouaz H Al-Mallah[SUP] 1 [/SUP]
Affiliations
- PMID: 37254693
- DOI: 10.1093/ehjci/jead118
Aims: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with endothelial dysfunction. We aimed to determine the effects of prior coronavirus disease 2019 (COVID-19) on the coronary microvasculature accounting for time from COVID-19, disease severity, SARS-CoV-2 variants, and in subgroups of patients with diabetes and those with no known coronary artery disease.
Methods and results: Cases consisted of patients with previous COVID-19 who had clinically indicated positron emission tomography (PET) imaging and were matched 1:3 on clinical and cardiovascular risk factors to controls having no prior infection. Myocardial flow reserve (MFR) was calculated as the ratio of stress to rest myocardial blood flow (MBF) in mL/min/g of the left ventricle. Comparisons between cases and controls were made for the odds and prevalence of impaired MFR (MFR < 2). We included 271 cases matched to 815 controls (mean ± SD age 65 ± 12 years, 52% men). The median (inter-quartile range) number of days between COVID-19 infection and PET imaging was 174 (58-338) days. Patients with prior COVID-19 had a statistically significant higher odds of MFR <2 (adjusted odds ratio 3.1, 95% confidence interval 2.8-4.25 P < 0.001). Results were similar in clinically meaningful subgroups. The proportion of cases with MFR <2 peaked 6-9 months from imaging with a statistically non-significant downtrend afterwards and was comparable across SARS-CoV-2 variants but increased with increasing severity of infection.
Conclusion: The prevalence of impaired MFR is similar by duration of time from infection up to 1 year and SARS-CoV-2 variants, but significantly differs by severity of infection.
Keywords: COVID; PET; coronary microvascular dysfunction.