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Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Arterial Stiffness, Clinical-Functional Outcomes, and Quality of Life in Post-COVID-19 Patients: A Cross-Sectional
Bruna Cavon Luna1, Ana Cristina Lamezon1, Emilton Lima Junior1
1Programa de Pós-graduação em Medicina Interna e Ciências da Saúde da Universidade Federal do Paraná, Curitiba, PR - Brasil.
Insights
Post-COVID-19 patients show increased arterial stiffness and worse functional outcomes. However, arterial stiffness is mainly linked to aging and hemodynamics, not solely to the post-COVID-19 condition itself.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Rehabilitation Medicine
Background:
- Arterial stiffness and remodeling are linked to oxidative stress, neuroendocrine changes, and genetics.
- These mechanisms are also implicated in COVID-19 pathophysiology.
- The impact of post-COVID-19 on arterial stiffness and hemodynamics remains under-investigated.
Purpose of the Study:
- To assess arterial stiffness, hemodynamic parameters, and clinical-functional outcomes in post-COVID-19 patients.
- To compare these parameters between post-COVID-19 patients and a control group.
- To understand the factors influencing arterial stiffness in the post-COVID-19 context.
Main Methods:
- A cross-sectional study comparing 32 post-COVID-19 patients with matched controls.
- Arterial stiffness measured by pulse wave velocity (PWV) and augmentation index (AIx@75).
- Functional performance, quality of life, fatigue, dyspnea, and sleep quality were assessed using validated scales.
Main Results:
- Post-COVID-19 patients exhibited significantly higher PWV and AIx@75, indicating increased arterial stiffness.
- Worse functional performance, poorer quality of life, increased fatigue, dyspnea, and impaired sleep quality were observed in the post-COVID-19 group.
- Higher central and peripheral blood pressure levels were also noted in post-COVID-19 patients.
Conclusions:
- Post-COVID-19 patients present with elevated arterial stiffness, altered hemodynamics, and diminished clinical-functional performance.
- Arterial stiffness is primarily associated with hemodynamic factors and age, rather than post-COVID-19 status alone.
- Functional impairments in post-COVID-19 patients likely stem from multifactorial causes.
Background:
Arterial remodeling leading to increased arterial stiffness involves mechanisms such as oxidative stress, reactive oxygen species production, neuroendocrine alterations, and genetic predisposition. These processes are also involved in the pathophysiology of COVID-19. However, the relationship between arterial stiffness, hemodynamic parameters, and clinical-functional outcomes in post-COVID-19 patients has not yet been adequately investigated.
Objectives:
To investigate arterial stiffness, central and peripheral hemodynamic parameters, functional performance, quality of life, fatigue, dyspnea, and sleep quality in post-COVID-19 patients.
Methods:
This cross-sectional study was conducted with individuals in the post-COVID-19 group (PCG) and matched individuals in the control group (n = 32). Arterial stiffness was assessed using pulse wave velocity (PWV) and the augmentation index corrected to a heart rate of 75 bpm (AIx@75). Functional performance was evaluated using the five-times sit-to-stand test, handgrip strength, quality of life (assessed with the 12-Item Short Form Survey), fatigue (assessed with the Brazilian version of the Fatigue Severity Scale), dyspnea (assessed with the modified Medical Research Council scale), and sleep quality.
Results:
The PCG showed higher PWV values (Δ = 0.80 m/s; 95%CI, 0.08 to 1.52; p = 0.03) and AIx@75 (Δ = 8.34; 95%CI, 2.02 to 14.66; p = 0.01) as well as higher levels of central and peripheral blood pressure. Worse functional performance was observed (Δ = 4.39 s; 95%CI, 2.70 to 6.08; p < 0.01), along with poorer quality of life in the physical component (Δ = -9.35; 95%CI, -12.45 to -6.25; p < 0.01). Fatigue, dyspnea, and sleep quality outcomes were also significantly worse in the PCG. In the adjusted analysis, PWV was independently associated with age and systolic blood pressure, but not with post-COVID-19 status.
Conclusion:
Post-COVID-19 patients exhibit greater arterial stiffness, hemodynamic alterations, and poorer clinical-functional performance. However, arterial stiffness appears to be predominantly determined by hemodynamic factors and aging rather than by post-COVID-19 status independently, suggesting that the observed functional impairment results from multifactorial mechanisms.
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