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MICROCIRCULATORY ALTERATIONS IN STABLE CORONARY ARTERY DISEASE PATIENTS WITH CONCOMITANT COVID-19
Vasyl Z Netiazhenko1, Serhii I Mostovyi2, Olga M Safonova3
1BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.
Insights
Stable coronary artery disease patients with COVID-19 show significant microcirculation changes, including capillary remodeling and reduced blood flow velocity. This highlights the impact of COVID-19 on vascular health in SCAD patients.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Microcirculation Research
Background:
- Stable coronary artery disease (SCAD) is a prevalent condition affecting millions globally.
- COVID-19 has been associated with various cardiovascular complications.
- The impact of concomitant COVID-19 on the microcirculation of SCAD patients remains incompletely understood.
Purpose of the Study:
- To investigate and characterize the alterations in microcirculation among patients with stable coronary artery disease (SCAD) who also have COVID-19.
- To compare microcirculatory parameters between SCAD patients with and without COVID-19, and with COVID-19 patients without SCAD.
Main Methods:
- A cross-sectional study involving 80 patients categorized into four groups: SCAD without COVID-19, SCAD with COVID-19, COVID-19 without SCAD, and healthy controls.
- Microcirculation was assessed using nailfold videocapillaroscopy (NVC) and laser Doppler flowmetry (LDF).
Main Results:
- Patients with SCAD and COVID-19 (G2) exhibited capillary bed remodeling and significantly reduced capillary blood flow velocity compared to other groups.
- Laser Doppler flowmetry revealed impaired endothelium-dependent and -independent microvascular regulation in G2.
- A high prevalence (72%) of microcirculatory hemodynamic "congestion-stasis" (MHCS) or mixed types with reduced microvascular reactivity (MVR) was observed in G2.
Conclusions:
- The microcirculatory profile in SCAD patients with COVID-19 is characterized by MHCS or mixed types with reduced MVR.
- A hyporeactive microcirculatory profile was significantly more frequent in SCAD patients with COVID-19 compared to those without.
- Concomitant COVID-19 significantly impacts microvascular function in patients with stable coronary artery disease.
Objective:
The aim: To evaluate the alterations in microcirculation of stable coronary artery disease (SCAD) patients with concomitant COVID-19.
Patients And Methods:
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:
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).
Conclusion:
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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