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Front Cardiovasc Med . Brief Research Report: Quantitative Analysis of Potential Coronary Microvascular Disease in Suspected Long-COVID Syndrome

tetano

Editor, Senior Moderator
Front Cardiovasc Med


. 2022 May 31;9:877416.
doi: 10.3389/fcvm.2022.877416. eCollection 2022.
Brief Research Report: Quantitative Analysis of Potential Coronary Microvascular Disease in Suspected Long-COVID Syndrome


Patrick Doeblin[SUP] 1 2 [/SUP], Fridolin Steinbeis[SUP] 3 [/SUP], Cian M Scannell[SUP] 4 [/SUP], Collin Goetze[SUP] 1 [/SUP], Sarah Al-Tabatabaee[SUP] 1 [/SUP], Jennifer Erley[SUP] 1 [/SUP], Alessandro Faragli[SUP] 1 [/SUP], Felix Pröpper[SUP] 1 [/SUP], Martin Witzenrath[SUP] 3 [/SUP], Thomas Zoller[SUP] 3 5 [/SUP], Christian Stehning[SUP] 6 [/SUP], Holger Gerhardt[SUP] 2 7 [/SUP], Javier Sánchez-González[SUP] 8 [/SUP], Ebraham Alskaf[SUP] 4 [/SUP], Titus Kühne[SUP] 2 9 [/SUP], Burkert Pieske[SUP] 1 2 10 [/SUP], Carsten Tschöpe[SUP] 2 10 11 [/SUP], Amedeo Chiribiri[SUP] 4 [/SUP], Sebastian Kelle[SUP] 1 2 10 [/SUP]



Affiliations

Abstract

Background: Case series have reported persistent cardiopulmonary symptoms, often termed long-COVID or post-COVID syndrome, in more than half of patients recovering from Coronavirus Disease 19 (COVID-19). Recently, alterations in microvascular perfusion have been proposed as a possible pathomechanism in long-COVID syndrome. We examined whether microvascular perfusion, measured by quantitative stress perfusion cardiac magnetic resonance (CMR), is impaired in patients with persistent cardiac symptoms post-COVID-19.
Methods: Our population consisted of 33 patients post-COVID-19 examined in Berlin and London, 11 (33%) of which complained of persistent chest pain and 13 (39%) of dyspnea. The scan protocol included standard cardiac imaging and dual-sequence quantitative stress perfusion. Standard parameters were compared to 17 healthy controls from our institution. Quantitative perfusion was compared to published values of healthy controls.
Results: The stress myocardial blood flow (MBF) was significantly lower [31.8 ± 5.1 vs. 37.8 ± 6.0 (μl/g/beat), P < 0.001] and the T2 relaxation time was significantly higher (46.2 ± 3.6 vs. 42.7 ± 2.8 ms, P = 0.002) post-COVID-19 compared to healthy controls. Stress MBF and T1 and T2 relaxation times were not correlated to the COVID-19 severity (Spearman r = -0.302, -0.070, and -0.297, respectively) or the presence of symptoms. The stress MBF showed a U-shaped relation to time from PCR to CMR, no correlation to T1 relaxation time, and a negative correlation to T2 relaxation time (Pearson r = -0.446, P = 0.029).
Conclusion: While we found a significantly reduced microvascular perfusion post-COVID-19 compared to healthy controls, this reduction was not related to symptoms or COVID-19 severity.

Keywords: CMR; COVID-19; long COVID-19 syndrome; microvascular disease; quantitative perfusion.
 
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