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

Abstract

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.

Clinical implications of vascular dysfunction in acute and convalescent COVID‐19: A systematic review

“…Eleven studies examined the potential link between COVID‐19 and arterial stiffness 10,11,17,19,26–32 . Patients with acute COVID‐19 had increased arterial stiffness compared with their counterparts without COVID‐19 27,28 .…”

“…Eleven studies examined the potential link between COVID-19 and arterial stiffness. 10,11,17,19,[26][27][28][29][30][31][32] Patients with acute COVID-19 had increased arterial stiffness compared with their counterparts without COVID-19. 27,28 In most studies 10,11,17,29 which assessed arterial stiffness, reflected either as PWV 10,11,17 or as aortic augmentation index, 29 in the recovery phase of COVID-19, patients of different age groups with prior SARS-CoV-2 infection had higher PWV values and aortic augmentation index in comparison to controls, even 48 weeks after COVID-19 onset.…”

Distinct Features of Vascular Diseases in COVID-19

“…For instance, fifty patients with a positive SARS-CoV-2 PCR test in the last 3 to 6 months showed a decreased aortic strain and aortic distensibility combined with an increased PP and aortic stiffness index. 53 In a longitudinal study by Zanoli et al, forty-one COVID-19 patients showed a higher aortic PWV approximately 5 months after the onset of infection. This measure of arterial stiffness significantly decreased but remained higher than in control individuals 1-year post-COVID-19.…”

Letter regarding the Published Article “Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging”

“…In the paper “Evaluation of Aortic Elasticity Parameters in Survivors of COVID-19 Using Echocardiography Imaging,” Küçük et al [ 1 ] mentioned that “ SARS-CoV-2 may cause reduced or impaired aortic elasticity parameters linked to impaired arterial wall function in COVID-19 survivors compared with controls .” We agree that COVID-19 may produce vascular abnormalities and that aortic elasticity may change as a result of COVID-19. Aortic enlargement and COVID-19 were also described in a recent publication [ 2 ].…”