Arterial stiffness and COVID‐19: A bidirectional cause‐effect relationship

Saeed, Sahrai; Mancia, Giuseppe

doi:10.1111/jch.14259

Cited by 26 publications

(25 citation statements)

References 32 publications

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“…The European Society of Cardiology endorses that close follow-up and further research is needed to address the potential therapeutic and prognostic implications of COVID-19-induced endotheliitis, recommending an arterial stiffness assessment as a marker of COVID-19 outcome and treatment monitoring [ 2 ]. Saeed et al have recently argued that COVID-19 and arterial stiffness have a bidirectional cause–effect association [ 73 ]. COVID-19-induced vascular remodeling is favored by dysregulation of the neuro-hormonal systems, endothelial dysfunction, renal damage, altered lipid and glucose metabolisms and decompensated hypertension [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

Acute and Long-Term Consequences of COVID-19 on Arterial Stiffness—A Narrative Review

Zota

Stătescu

Sascău

et al. 2022

Life

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the ongoing global coronavirus (COVID-19) pandemic. Although initially viewed as an acute respiratory illness, COVID-19 is clearly a complex multisystemic disease with extensive cardiovascular involvement. Emerging evidence shows that the endothelium plays multiple roles in COVID-19 physiopathology, as both a target organ that can be directly infected by SARS-CoV-2 and a mediator in the subsequent inflammatory and thrombotic cascades. Arterial stiffness is an established marker of cardiovascular disease. The scope of this review is to summarize available data on the acute and long-term consequences of COVID-19 on vascular function. COVID-19 causes early vascular aging and arterial stiffness. Fast, noninvasive bedside assessment of arterial stiffness could optimize risk stratification in acute COVID-19, allowing for early escalation of treatment. Vascular physiology remains impaired at least 12 months after infection with SARS-CoV-2, even in otherwise healthy adults. This raises concerns regarding the extent of arterial remodeling in patients with preexisting vascular disease and the potential development of a persistent, chronic COVID-19 vasculopathy. Long-term follow up on larger cohorts is required to investigate the reversibility of COVID-19-induced vascular changes and their associated prognostic implications.

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Section: Discussionmentioning

confidence: 99%

Acute and Long-Term Consequences of COVID-19 on Arterial Stiffness—A Narrative Review

Zota

Stătescu

Sascău

et al. 2022

Life

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“…In addition, other mechanisms (subintimal bleeding, edema, inflammation, etc.) are believed to be key elements in the pathogenesis of arterial damage [ 19 ]. Endothelial damage and subsequent atherosclerotic processes cause thickening and stiffness of the tunica media layer as the prevalence and severity of atherosclerosis increases, leading to arterial stiffness [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging

et al. 2022

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Objective: While SARS-CoV-2 primarily affects lung tissue, it may cause direct or indirect damage to the cardiovascular system and permanent damage may occur. Arterial stiffness is an early indicator of cardiovascular disease risk. The aim of our study was to establish the potential effects of SARS-CoV-2 on the vascular system evaluated by transthoracic echocardiographic (TTE) examination. Subjects and Methods: This study compared arterial stiffness between the survivors of COVID-19 and those without a history of COVID-19 infection. The difference in aortic diameter was examined using echocardiography. Results: The study included 50 patients who survived COVID-19 in the last 3 to 6 months and 50 age- and gender-matched healthy volunteers. In surviving COVID-19 patients, aortic diastolic diameter in cm ([3.1±0.2] vs. [2.9±0.1], p < 0.001), pulse pressure ([43.02±14.05] vs [35.74±9.86], p = 0.004), aortic distensibility ([5.61±3.57] vs [8.31±3.82], p < 0.001), aortic strain ([10.56±4.91] vs [13.88±5.86], p = 0.003), pulse pressure/stroke volume index ([1.25±0.47] vs [0.98±0.28], p = 0.001) and aortic stiffness index ([2.82±0.47] vs [2.46±0.45], p < 0.001) were statistically significant compared to the control group. Conclusion: SARS-CoV-2 may cause reduced or impaired aortic elasticity parameters linked to impaired arterial wall function in COVID-19 survivors compared with controls.

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“…The main organs involved in COVID-19, i.e., the lungs, the heart, and the kidneys, exhibit similar findings of endothelial dysfunction and vasculitis with monoclonal cells, lymphocyte infiltration and intravascular thrombosis. 2 Transient increase of arterial stiffness that is associated with hospital stay length 3 attests to the vascular involvement in COVID-19. Nevertheless, the patients that end up with irreversible myocardial damage at long-term follow constitute a small percentage.…”

Section: Introductionmentioning

confidence: 99%

Time-related aortic inflammatory response, as assessed with 18F-FDG PET/CT, in patients hospitalized with severely or critical COVID-19: the COVAIR study

Vlachopoulos

Terentes‐Printzios

Κatsaounou³

et al. 2023

Journal of Nuclear Cardiology

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Aim Arterial involvement has been implicated in the coronavirus disease of 2019 (COVID-19). Fluorine 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging is a valuable tool for the assessment of aortic inflammation and is a predictor of outcome. We sought to prospectively assess the presence of aortic inflammation and its time-dependent trend in patients with COVID-19. Methods Between November 2020 and May 2021, in this pilot, case-control study, we recruited 20 patients with severe or critical COVID-19 (mean age of 59 ± 12 years), while 10 age and sex-matched individuals served as the control group. Aortic inflammation was assessed by measuring 18 F-FDG uptake in PET/CT performed 20-120 days post-admission. Global aortic target to background ratio (GLA-TBR) was calculated as the sum of TBRs of ascending and descending aorta, aortic arch, and abdominal aorta divided by 4. Index aortic segment TBR (IAS-TBR) was designated as the aortic segment with the highest TBR. Results There was no significant difference in aortic 18 F-FDG PET/CT uptake between patients and controls (GLA-TBR: 1.46 [1.40-1.57] vs. 1.43 [1.32-1.70], respectively, P = 0.422 and IAS-TBR: 1.60 [1.50-1.67] vs. 1.50 [1.42-1.61], respectively, P = 0.155). There was a moderate correlation between aortic TBR values (both GLA and IAS) and time distance from admission to 18 F-FDG PET-CT scan (Spearman’s rho = − 0.528, P = 0.017 and Spearman’s rho = − 0.480, p = 0.032, respectively). Patients who were scanned less than or equal to 60 days from admission (n = 11) had significantly higher GLA-TBR values compared to patients that were examined more than 60 days post-admission (GLA-TBR: 1.53 [1.42-1.60] vs. 1.40 [1.33-1.45], respectively, P = 0.016 and IAS-TBR: 1.64 [1.51-1.74] vs. 1.52 [1.46-1.60], respectively, P = 0.038). There was a significant difference in IAS- TBR between patients scanned ≤ 60 days and controls (1.64 [1.51-1.74] vs. 1.50 [1.41-1.61], P = 0.036). Conclusion This is the first study suggesting that aortic inflammation, as assessed by 18 F-FDG PET/CT imaging, is increased in the early post COVID phase in patients with severe or critical COVID-19 and largely resolves over time. Our findings may have important implications for the understanding of the course of the disease and for improving our preventive and therapeutic strategies. Supplementary Information The online version contains supplementary material available at 10.1007/s12350-022-02962-1.

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Arterial stiffness and COVID‐19: A bidirectional cause‐effect relationship

Cited by 26 publications

References 32 publications

Acute and Long-Term Consequences of COVID-19 on Arterial Stiffness—A Narrative Review

Acute and Long-Term Consequences of COVID-19 on Arterial Stiffness—A Narrative Review

Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging

Time-related aortic inflammatory response, as assessed with 18F-FDG PET/CT, in patients hospitalized with severely or critical COVID-19: the COVAIR study

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