Increased Angio-Derived Index of Microcirculatory Resistance Within a Timeframe of 30–60 days After COVID-19 Infection, 2024, Dong et al.

Increased Angio-Derived Index of Microcirculatory Resistance Within a Timeframe of 30–60 days After COVID-19 Infection
Lei Dong; Ritai Na; Lang Peng; Xinye Xu

BACKGROUND AND OBJECTIVES
Chest pain is a relatively long-term symptom that commonly occurs in patients who have contracted COVID-19. The reasons for these symptoms remain unclear, with coronary microvascular dysfunction (CMD) emerging as a potential factor. This study aimed to assess the presence of CMD in these patients by measuring the angio-derived index of microcirculatory resistance (AMR).

METHODS
In this cross-sectional case–control study, patients who had chest pain and a history of COVID-19 infection within the preceding 30 to 60 days were included. The control subjects were patients without COVID-19. Demographic, clinical, and echocardiographic data were recorded. Angiographic images were collected for AMR analysis through an angioplus quantitative flow ratio measurement system. Propensity score matching (PSM) was performed to match the two groups. Multivariate logistic regression was used to examine the association between COVID-19 incidence and the increase in AMR (AMR > 285 mmHg*s/m) after correction for other confounders.

RESULTS
After PSM, there were 58 patients in each group (the mean age was 66.3 ± 9.04 years, and 55.2% were men). The average time between the onset of COVID-19 infection and patient presentation at the hospital for coronary angiography was 41 ± 9.5 days. Moreover, there was no significant difference in the quantitative flow ratio between the two groups.

Patients with COVID-19 had a greater mean AMR (295 vs. 266, p = 0.002). Multivariate logistic regression analysis revealed that COVID-19 (OR = 3.32, 95% CI = 1.50–7.60, p = 0.004) was significantly associated with an increase in AMR.

CONCLUSIONS
Long-term COVID-19 patients who experience chest pain without evidence of myocardial ischemia exhibit an increase in AMR, and CMD may be one of the reasons for this increase. COVID-19 is an independent risk factor for an increase in AMR.

Link | PDF (Microcirculation)

 

Is this more evidence of Endothelial dysfunction in Long Covid?

 

I wonder whether a similar thing happens with the chest pain in ME/CFS. I remember getting it first as a teenager. I wondered was a heart attack but figured I was probably safe given my age and that I wasn’t overweight and had never been overweight.