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Prior SARS-CoV-2 Infection Is Associated With Coronary Vasomotor Dysfunction as Assessed by Coronary Flow Reserve

Brittany Weber1,2, Sean Parks1,2, Daniel M Huck1,2

  • 1Cardiovascular Imaging Program, Departments of Medicine and Radiology Brigham and Women's Hospital, Harvard Medical School Boston MA.

Journal of the American Heart Association
|October 17, 2022
PubMed

Insights

COVID-19 infection significantly impairs coronary vascular health, leading to reduced myocardial blood flow reserve in patients months after recovery. This suggests long-term cardiovascular consequences of SARS-CoV-2 infection require further investigation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Biology

Background:

  • Cardiovascular complications are a major cause of COVID-19 morbidity and mortality.
  • The impact of COVID-19 on coronary vasculature remains largely unknown.
  • Understanding post-COVID-19 vascular health is crucial for long-term patient management.

Purpose of the Study:

  • To investigate the prevalence of coronary vasomotor dysfunction in patients with prior COVID-19 infection.
  • To assess coronary flow reserve using cardiac positron emission tomography (PET) in post-COVID-19 patients.
  • To identify potential long-term effects of SARS-CoV-2 on coronary vascular function.

Main Methods:

  • Comparison of patients with polymerase chain reaction-confirmed SARS-CoV-2 infection against a matched control group.
  • Utilized N13-ammonia cardiac positron emission tomography (PET) for myocardial stress perfusion imaging.
  • Quantified myocardial perfusion and myocardial blood flow reserve (MBFR).

Main Results:

  • 44.0% of COVID-19 patients exhibited abnormal myocardial blood flow reserve (<2) compared to 11.7% of controls (P<0.001).
  • Mean MBFR was 19.4% lower in the COVID-19 group (2.00±0.45) versus controls (2.48±0.47).
  • Abnormal myocardial perfusion was observed in 53% of COVID-19 patients.

Conclusions:

  • Prior COVID-19 infection is associated with impaired myocardial blood flow reserve.
  • Findings suggest a link between SARS-CoV-2 infection and compromised coronary vascular health.
  • Further prospective studies are needed to evaluate the long-term vascular consequences of COVID-19.

Keywords:
COVID‐19Cardiac PETSARS‐CoV‐2coronary vasomotor dysfunction

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