Coronary microvascular dysfunction and COVID-19: implications for long COVID patients

Malahfji, Maan; Crudo, Valentina; Ahmed, Ahmed Ibrahim; Saeed, Mujtaba; Saad, Jean Michel; Zoghbi, William A.; Al‐Mallah, Mouaz H.

doi:10.1007/s12350-022-03073-7

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…A few case reports and limited studies have suggested the presence of CMD using noninvasive imaging modalities in patients who experienced angina after recovering from COVID‐19 infection 5–8 . Vallejo et al reported circumferential subendocardial perfusion defects using cardiac magnetic resonance imaging (MRI) in a young healthy female who experienced angina a month after recovering from a severe COVID‐19 infection 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Vallejo et al reported circumferential subendocardial perfusion defects using cardiac magnetic resonance imaging (MRI) in a young healthy female who experienced angina a month after recovering from a severe COVID‐19 infection 5 . Another case report by Malahfji et al, reported a low global myocardial flow reserve (MFR) of 1.34 on cardiac PET consistent with CMD in a middle‐aged obese female who experienced angina 4 weeks after recovering from COVID‐19 infection 6 . A case series of 22 post‐COVID‐19 patients with persistent exertional dyspnea and fatigue after recovering from nonsevere COVID‐19 infection found a significantly reduced global MPR using cardiac MRI compared with healthy controls (2.73 vs. 4.82, p = 0.005) 7 .…”

Section: Discussionmentioning

confidence: 99%

“…COVID-19 infection. 6 A case series of 22 post-COVID-19 patients with persistent exertional dyspnea and fatigue after recovering from nonsevere COVID-19 infection found a significantly reduced global MPR using cardiac MRI compared with healthy controls (2.73 vs.…”

Section: Discussionmentioning

confidence: 99%

“…4 A growing body of evidence including various case reports and studies suggest that post-COVID-19 patients are at risk for coronary microvascular dysfunction (CMD). [5][6][7][8][9] We report a case of a young female presenting with concomitant COVID-19 infection and STEMI, likely due to microvascular thrombi with subsequent development of CMD 3 months after the index presentationsuggesting a possible mechanism for the development of CMD in Long COVID.…”

Section: Introductionmentioning

confidence: 87%

“…The ongoing COVID‐19 pandemic has led to a growing concern regarding its long‐term effects on various systems, including the cardiovascular system. This syndrome is frequently referred to as “Long COVID.” 4 A growing body of evidence including various case reports and studies suggest that post‐COVID‐19 patients are at risk for coronary microvascular dysfunction (CMD) 5–9 . We report a case of a young female presenting with concomitant COVID‐19 infection and STEMI, likely due to microvascular thrombi with subsequent development of CMD 3 months after the index presentation‐suggesting a possible mechanism for the development of CMD in Long COVID.…”

Section: Introductionmentioning

confidence: 96%

See 4 more Smart Citations

COVID‐19 STEMI related to microthrombi may lead to coronary microvascular dysfunction

Aziz,

Yildiz,

Quesada

et al. 2023

Cathet Cardio Intervent

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Coronavirus disease 2019 (COVID‐19) increases the risk of ST‐segment elevation myocardial infarction (STEMI), and is associated with a higher occurrence of nonobstructive coronary artery disease. We present a unique case of STEMI with concomitant COVID‐19 infection in a young female found to have slow flow in multiple vessels on angiography, likely due to microvascular thrombi. Three months later, the patient developed coronary microvascular dysfunction (CMD), suggesting an evolution of microvascular thrombi and injury into subsequent CMD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

COVID‐19 STEMI related to microthrombi may lead to coronary microvascular dysfunction

Aziz,

Yildiz,

Quesada

et al. 2023

Cathet Cardio Intervent

View full text Add to dashboard Cite

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The role of cardiac PET in diagnosis and prognosis of patients with ischemia with no obstructive coronary arteries (INOCA)

Al-Mallah,

Nayfeh,

Alrifai

2024

American Heart Journal Plus: Cardiology Research and Practice

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Microcirculatory Alterations in Stable Coronary Artery Disease Patients With Concomitant Covid-19

Netiazhenko,

Mostovyi,

Safonova

et al. 2023

Wiad Lek

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The aim: To evaluate the alterations in microcirculation of stable coronary artery disease (SCAD) patients with concomitant COVID-19. Materials and methods: The cross-sectional study analyzed the data from 80 patients, being subdivided as follows: group 1 (G1) – SCAD without COVID-19 (n=30); group 2 (G2) – SCAD with concomitant COVID-19 (n=25); group 3 (G3) – COVID-19 without SCAD (n=25). The control group included 30 relatively healthy volunteers. The state of microcirculation was assessed by nailfold videocapillaroscopy (NVC) and laser Doppler flowmetry (LDF). Results: NVC data from G2 revealed the sings of capillary bed remodeling, along with the most pronounced decrease in capillary (arteriolar part of the loop) blood flow velocity (vs. G1 and G3). LDF data from G2 were evident for the alterations in both endothelium-dependent and -independent mechanisms of microvascular flow regulation. The 72 % of G2 constituted the cases of microcirculatory hemodynamic «congestion-stasis» (MHCS) type (characterized by the decreased laser Doppler perfusion index and reduced endothelium-dependent microvascular reactivity [MVR]), and the cases of mixed type with reduced MVR. The pooled hyporeactive profile (of both MHCS type and a mixed type with reduced MVR) demonstrated the higher frequency of G2 patients (40 %), as against 11 % in the pooled alternative hemodynamic group (p<0,001) (included 80 % of cases with preserved MVR). Conclusions: G2 profile demonstrated the predomination of patients, possessing a MHCS type or a mixed type with reduced MVR. The pooled microcirculatory hyporeactive profile was presented with G2 cases to a greater extent, than in the pooled profile with predominantly preserved MVR.

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Coronary microvascular dysfunction and COVID-19: implications for long COVID patients

Cited by 3 publications

References 2 publications

COVID‐19 STEMI related to microthrombi may lead to coronary microvascular dysfunction

COVID‐19 STEMI related to microthrombi may lead to coronary microvascular dysfunction

The role of cardiac PET in diagnosis and prognosis of patients with ischemia with no obstructive coronary arteries (INOCA)

Microcirculatory Alterations in Stable Coronary Artery Disease Patients With Concomitant Covid-19

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