Impact of severe COVID-19 infection on coronary microvascular dysfunction in ANOCA patients: A cross-sectional study

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-06-02 DOI:10.1016/j.atherosclerosis.2025.120389

Ali Aldujeli , Tsung-Ying Tsai , Ayman Haq , Kamile Puipaite , Rima Braukyliene , Vacis Tatarunas , Diana Zaliaduonyte , Ramunas Unikas , Mick Renkens , Pruthvi C. Revaiah , Kotaro Miyashita , Akihiro Tobe , Asahi Oshima , Faisal Sharif , Vaiva Lesauskaite , John A. Spertus , Scot Garg , Yoshinobu Onuma , Emmanouil S. Brilakis , Patrick W. Serruys

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引用次数: 0

Abstract

Background and aims

Millions of survivors from severe COVID-19 infection suffer from residual symptoms including anginal chest pain. The pathophysiological mechanisms, particularly the role of coronary microvascular dysfunction (CMD), however, remain elusive. We compared the incidence and endotypes of CMD in patients with angina without obstructive coronary artery disease (ANOCA) between those who had a history of severe COVID-19 infection (COVID group, defined as COVID patients needing supplemental oxygen therapy with SpO2 < 90 % on room air), versus those who didn't (Control group).

Methods

This multicentre, prospective cohort study enrolled 117 ANOCA patients (COVID group n = 59, Control group n = 58). All participants underwent exercise stress testing and invasive coronary physiology assessment to measure coronary flow reserve (CFR), and the index of microvascular resistance (IMR). CMD was defined as CFR<2.0 or IMR≥25. Patients also completed the modified Seattle Angina Questionnaire (SAQ-7) after invasive functional assessment.

Results

CMD was diagnosed in 42 patients (35.9 %): 47.5 % in the COVID group and 24.1 % in the Control group (p = 0.015). The prevalence of structural CMD was significantly higher in the COVID group (28.8 % vs. 5.2 %, p < 0.001). The median IMR was significantly higher in the COVID versus the Control group (20.00 [15.00, 42.00] vs. 17.00 [12.00, 21.00], p = 0.002) while no significant differences were observed in CFR and FFR. The SAQ-7 summary scores (54.44 vs. 59.44, p = 0.003) and physical limitation and quality-of-life domain scores were all significantly lower in the COVID group.

Conclusions

The incidence of CMD, particularly structural CMD, was higher in ANOCA patients with a history of severe COVID-19 infection, suggesting a link between persistent angina and CMD in this population.

查看原文本刊更多论文

严重COVID-19感染对ANOCA患者冠状动脉微血管功能障碍的影响：一项横断面研究

背景和目的数百万COVID-19严重感染的幸存者仍有包括心绞痛性胸痛在内的残留症状。然而，其病理生理机制，特别是冠状动脉微血管功能障碍（CMD）的作用仍然难以捉摸。我们比较了无阻塞性冠状动脉疾病（ANOCA）心绞痛患者中有严重COVID-19感染史(COVID组，定义为需要SpO2和lt辅助氧疗的COVID患者；90%的人使用室内空气)，而不使用室内空气的人（对照组）。方法本研究是一项多中心前瞻性队列研究，纳入117例ANOCA患者，其中COVID组59例，对照组58例。所有参与者都进行了运动应激测试和有创冠状动脉生理学评估，以测量冠状动脉血流储备（CFR）和微血管阻力指数（IMR）。CMD定义为cfr2.0或IMR≥25。患者在有创功能评估后完成改良的西雅图心绞痛问卷（SAQ-7）。结果确诊scmd 42例（35.9%），其中新冠肺炎组47.5%，对照组24.1% （p = 0.015）。结构性CMD的患病率在COVID组中明显更高(28.8% vs. 5.2%, p <；0.001)。新冠肺炎患者的中位IMR显著高于对照组（20.00 [15.00,42.00]vs. 17.00 [12.00, 21.00], p = 0.002），而CFR和FFR无显著差异。SAQ-7综合得分（54.44比59.44,p = 0.003）、身体限制和生活质量领域得分均显著低于COVID组。结论有严重COVID-19感染史的ANOCA患者的CMD发病率，特别是结构性CMD的发病率更高，提示该人群中持续性心绞痛与CMD之间存在联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.