Related Experiment Video

Updated: May 8, 2026

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
08:35

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

Endothelial and cardiac dysfunction in long COVID With cardiovascular symptoms is associated with imbalance in the

Mohamed Saad Rakab1, Imaduddin Mirza2, Mohamed M Ali3

  • 1Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Frontiers in Cardiovascular Medicine
|May 7, 2026
PubMed

Insights

Post-acute sequelae of COVID-19 (PASC) with cardiovascular symptoms show an imbalanced ADMA-DDAH-NOx axis, leading to endothelial dysfunction. This highlights a potential therapeutic target for PASC cardiovascular complications.

Area of Science:

  • Cardiovascular Research
  • COVID-19 Pathophysiology
  • Endothelial Function

Background:

  • Post-acute sequelae of COVID-19 (PASC) often involve persistent cardiovascular issues with unclear mechanisms.
  • The ADMA-DDAH-NOx axis regulates endothelial function, but its role in PASC cardiovascular pathology is unknown.

Purpose of the Study:

  • To investigate the ADMA-DDAH-NOx axis and its association with endothelial and cardiac dysfunction in PASC patients.

Main Methods:

  • Integrated vascular and cardiac phenotyping in 49 participants: controls, PASC-, and PASC+.
  • Measured ADMA, DDAH, NOx, inflammatory markers, endothelial function (FMD), and cardiac structure/function (echocardiography).

Main Results:

  • PASC+ group showed higher inflammation, thrombosis (D-dimer, hs-CRP), and ADMA levels with lower NOx.
  • Endothelial function (FMD) and cardiac mechanics were significantly impaired in PASC+.
  • PASC+ individuals had elevated cardiac biomarkers (hs-troponin, NT-proBNP) and reduced ejection fraction.

Conclusions:

  • An imbalanced ADMA-DDAH-NOx axis is linked to endothelial dysfunction and cardiac involvement in PASC.
  • This pathway represents a potential target for risk stratification and therapeutic strategies in PASC.
Abstract

Keywords:
COVID-19cardiac dysfucntionendothel dysfunctionnitric oxidvascular dysfucntion

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