A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients
Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is primarily characterised by a respiratory disease. However, SARS-CoV-2 can directly infect vascular endothelium and subsequently cause vascular inflammation, atherosclerotic p...
Guardado en:
Autores principales: | , , , , , , , , |
---|---|
Formato: | article |
Lenguaje: | EN |
Publicado: |
Nature Portfolio
2021
|
Materias: | |
Acceso en línea: | https://doaj.org/article/89af65b848f14659ab3f77e304c45c98 |
Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
id |
oai:doaj.org-article:89af65b848f14659ab3f77e304c45c98 |
---|---|
record_format |
dspace |
spelling |
oai:doaj.org-article:89af65b848f14659ab3f77e304c45c982021-12-02T17:06:10ZA cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients10.1038/s41598-021-95277-z2045-2322https://doaj.org/article/89af65b848f14659ab3f77e304c45c982021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95277-zhttps://doaj.org/toc/2045-2322Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is primarily characterised by a respiratory disease. However, SARS-CoV-2 can directly infect vascular endothelium and subsequently cause vascular inflammation, atherosclerotic plaque instability and thereby result in both endothelial dysfunction and myocardial inflammation/infarction. Interestingly, up to 50% of patients suffer from persistent exercise dyspnoea and a post-viral fatigue syndrome (PVFS) after having overcome an acute COVID-19 infection. In the present study, we assessed the presence of coronary microvascular disease (CMD) by cardiovascular magnetic resonance (CMR) in post-COVID-19 patients still suffering from exercise dyspnoea and PVFS. N = 22 patients who recently recovered from COVID-19, N = 16 patients with classic hypertrophic cardiomyopathy (HCM) and N = 17 healthy control patients without relevant cardiac disease underwent dedicated vasodilator-stress CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as velocity-encoded (VENC) phase-contrast imaging of the coronary sinus flow (CSF) at rest and during pharmacological stress (maximal vasodilation induced by 400 µg IV regadenoson). Using CSF measurements at rest and during stress, global myocardial perfusion reserve (MPR) was calculated. There was no difference in left ventricular ejection-fraction (LV-EF) between COVID-19 patients and controls (60% [57–63%] vs. 63% [60–66%], p = NS). There were only N = 4 COVID-19 patients (18%) showing a non-ischemic pattern of LGE. VENC-based flow measurements showed that CSF at rest was higher in COVID-19 patients compared to controls (1.78 ml/min [1.19–2.23 ml/min] vs. 1.14 ml/min [0.91–1.32 ml/min], p = 0.048). In contrast, CSF during stress was lower in COVID-19 patients compared to controls (3.33 ml/min [2.76–4.20 ml/min] vs. 5.32 ml/min [3.66–5.52 ml/min], p = 0.05). A significantly reduced MPR was calculated in COVID-19 patients compared to healthy controls (2.73 [2.10–4.15–11] vs. 4.82 [3.70–6.68], p = 0.005). No significant differences regarding MPR were detected between COVID-19 patients and HCM patients. In post-COVID-19 patients with persistent exertional dyspnoea and PVFS, a significantly reduced MPR suggestive of CMD—similar to HCM patients—was observed in the present study. A reduction in MPR can be caused by preceding SARS-CoV-2-associated direct as well as secondary triggered mechanisms leading to diffuse CMD, and may explain ongoing symptoms of exercise dyspnoea and PVFS in some patients after COVID-19 infection.Stefanos DrakosGrigorios ChatzantonisMichael BietenbeckGeorg EversArik Bernard SchulzeMichael MohrHelena FonfaraClaudia MeierAli YilmazNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) |
institution |
DOAJ |
collection |
DOAJ |
language |
EN |
topic |
Medicine R Science Q |
spellingShingle |
Medicine R Science Q Stefanos Drakos Grigorios Chatzantonis Michael Bietenbeck Georg Evers Arik Bernard Schulze Michael Mohr Helena Fonfara Claudia Meier Ali Yilmaz A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
description |
Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and is primarily characterised by a respiratory disease. However, SARS-CoV-2 can directly infect vascular endothelium and subsequently cause vascular inflammation, atherosclerotic plaque instability and thereby result in both endothelial dysfunction and myocardial inflammation/infarction. Interestingly, up to 50% of patients suffer from persistent exercise dyspnoea and a post-viral fatigue syndrome (PVFS) after having overcome an acute COVID-19 infection. In the present study, we assessed the presence of coronary microvascular disease (CMD) by cardiovascular magnetic resonance (CMR) in post-COVID-19 patients still suffering from exercise dyspnoea and PVFS. N = 22 patients who recently recovered from COVID-19, N = 16 patients with classic hypertrophic cardiomyopathy (HCM) and N = 17 healthy control patients without relevant cardiac disease underwent dedicated vasodilator-stress CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as velocity-encoded (VENC) phase-contrast imaging of the coronary sinus flow (CSF) at rest and during pharmacological stress (maximal vasodilation induced by 400 µg IV regadenoson). Using CSF measurements at rest and during stress, global myocardial perfusion reserve (MPR) was calculated. There was no difference in left ventricular ejection-fraction (LV-EF) between COVID-19 patients and controls (60% [57–63%] vs. 63% [60–66%], p = NS). There were only N = 4 COVID-19 patients (18%) showing a non-ischemic pattern of LGE. VENC-based flow measurements showed that CSF at rest was higher in COVID-19 patients compared to controls (1.78 ml/min [1.19–2.23 ml/min] vs. 1.14 ml/min [0.91–1.32 ml/min], p = 0.048). In contrast, CSF during stress was lower in COVID-19 patients compared to controls (3.33 ml/min [2.76–4.20 ml/min] vs. 5.32 ml/min [3.66–5.52 ml/min], p = 0.05). A significantly reduced MPR was calculated in COVID-19 patients compared to healthy controls (2.73 [2.10–4.15–11] vs. 4.82 [3.70–6.68], p = 0.005). No significant differences regarding MPR were detected between COVID-19 patients and HCM patients. In post-COVID-19 patients with persistent exertional dyspnoea and PVFS, a significantly reduced MPR suggestive of CMD—similar to HCM patients—was observed in the present study. A reduction in MPR can be caused by preceding SARS-CoV-2-associated direct as well as secondary triggered mechanisms leading to diffuse CMD, and may explain ongoing symptoms of exercise dyspnoea and PVFS in some patients after COVID-19 infection. |
format |
article |
author |
Stefanos Drakos Grigorios Chatzantonis Michael Bietenbeck Georg Evers Arik Bernard Schulze Michael Mohr Helena Fonfara Claudia Meier Ali Yilmaz |
author_facet |
Stefanos Drakos Grigorios Chatzantonis Michael Bietenbeck Georg Evers Arik Bernard Schulze Michael Mohr Helena Fonfara Claudia Meier Ali Yilmaz |
author_sort |
Stefanos Drakos |
title |
A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
title_short |
A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
title_full |
A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
title_fullStr |
A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
title_full_unstemmed |
A cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in COVID-19 patients |
title_sort |
cardiovascular magnetic resonance imaging-based pilot study to assess coronary microvascular disease in covid-19 patients |
publisher |
Nature Portfolio |
publishDate |
2021 |
url |
https://doaj.org/article/89af65b848f14659ab3f77e304c45c98 |
work_keys_str_mv |
AT stefanosdrakos acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT grigorioschatzantonis acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT michaelbietenbeck acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT georgevers acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT arikbernardschulze acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT michaelmohr acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT helenafonfara acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT claudiameier acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT aliyilmaz acardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT stefanosdrakos cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT grigorioschatzantonis cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT michaelbietenbeck cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT georgevers cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT arikbernardschulze cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT michaelmohr cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT helenafonfara cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT claudiameier cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients AT aliyilmaz cardiovascularmagneticresonanceimagingbasedpilotstudytoassesscoronarymicrovasculardiseaseincovid19patients |
_version_ |
1718381686747561984 |