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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Related Experiment Video

Updated: Dec 5, 2025

Author Spotlight: A Pharmacodissection Approach to Uncover Mechanisms in Cardiovascular Disease Risk Populations
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Microvascular dysfunction in COVID-19: the MYSTIC study.

Alexandros Rovas1, Irina Osiaevi1, Konrad Buscher1

  • 1Department of Medicine D, Division of General Internal and Emergency Medicine, Nephrology, and Rheumatology, University Hospital Münster, Albert-Schweitzer- Campus 1, 48149, Münster, Germany.

Angiogenesis
|October 15, 2020
PubMed
Summary
This summary is machine-generated.

COVID-19 significantly damages the microcirculation, reducing vascular density and red blood cell velocity. This study highlights severe endothelial glycocalyx damage in patients, suggesting a critical role for vascular health in disease progression.

Keywords:
COVID-19Endothelial glycocalyxEndotheliopathyMicrocirculationSublingual microscopy

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Area of Science:

  • Cardiovascular Research
  • Pulmonology
  • Infectious Diseases

Background:

  • COVID-19 pathogenesis may involve vascular endothelium dysfunction, impacting ARDS and multi-organ failure.
  • Pre-clinical and autopsy studies suggest a central role for dysregulated vascular endothelium.

Purpose of the Study:

  • To comprehensively characterize and quantify microvascular alterations in COVID-19 patients.
  • To investigate the role of endothelial glycocalyx in COVID-19.

Main Methods:

  • Prospective, observational, cross-sectional study of 23 hospitalized COVID-19 patients and 15 healthy controls.
  • Intravital microscopy (sidestream dark field imaging) assessed vascular density, red blood cell velocity (VRBC), and glycocalyx dimensions (PBR).
  • Circulating endothelial and glycocalyx markers measured via multiplex assays and ELISA.

Main Results:

  • COVID-19 patients exhibited up to 90% reduction in vascular density, primarily in small capillaries.
  • Significant reductions in VRBC and severe glycocalyx damage (higher PBR) observed, especially in ventilated patients.
  • Elevated endothelial dysfunction markers correlated with disease severity; PBR, ADAMTS13, and VEGF-A predicted mortality.

Conclusions:

  • Severe microcirculation and endothelial glycocalyx alterations are evident in COVID-19 patients.
  • Systemic vascular involvement is a critical factor in COVID-19.
  • Future therapies should address the systemic vascular impact of COVID-19.