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Post-Acute COVID-19 Syndrome: Prevalence of Peripheral Microvascular Endothelial Dysfunction and Associations With
Marcus Ståhlberg1, Katarina Fischer1, Maged Tahhan1
1Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Microvascular endothelial dysfunction is common in post-acute COVID-19 syndrome (PACS) patients. This dysfunction is linked to increased NT-proBNP levels, suggesting a connection between heart strain and blood vessel issues long after infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- Post-acute COVID-19 syndrome (PACS) may stem from microvascular endothelial dysfunction, even after mild infections.
- The prevalence of microvascular endothelial dysfunction and natriuretic peptides in PACS is not well understood.
Purpose of the Study:
- To determine the prevalence of microvascular endothelial dysfunction and circulating natriuretic peptides in patients with PACS.
- To explore the relationship between endothelial function and natriuretic peptide levels in PACS.
Main Methods:
- Prospective, cross-sectional cohort study of 92 PACS patients (82% female, median age 48).
- Microvascular endothelial function assessed via reactive hyperemia index (RHI) using peripheral arterial tonometry.
- N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels measured over one year.
Main Results:
- 41% of PACS patients exhibited microvascular endothelial dysfunction, and 20% had impaired RHI.
- Increased NT-proBNP levels over time were observed only in patients with microvascular endothelial dysfunction or impaired function.
- A significant correlation was found between NT-proBNP increase and lower RHI, persisting in multivariable analysis.
Conclusions:
- Peripheral microvascular endothelial dysfunction is prevalent in symptomatic PACS patients long after acute infection.
- Elevated NT-proBNP levels are associated with microvascular endothelial dysfunction in PACS.
- Findings suggest a link between endothelial dysfunction and cardiac markers in PACS, warranting further research.
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