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年轻人中与 SARS-CoV-2 相关的血管改变。

Vascular alterations among young adults with SARS-CoV-2.

机构信息

Department of Health & Exercise Science, Appalachian State University, Boone, North Carolina.

出版信息

Am J Physiol Heart Circ Physiol. 2021 Jan 1;320(1):H404-H410. doi: 10.1152/ajpheart.00897.2020. Epub 2020 Dec 11.

Abstract

While SARS-CoV-2 primarily affects the lungs, the virus may be inflicting detriments to the cardiovascular system, both directly through angiotensin-converting enzyme 2 receptor and initiating systemic inflammation. Persistent systemic inflammation may be provoking vascular dysfunction, an early indication of cardiovascular disease risk. To establish the potential effects of SARS-CoV-2 on the systemic vasculature in the arms and legs, we performed a cross-sectional analysis of young healthy adults (control: 5 M/15 F, 23.0 ± 1.3 y, 167 ± 9 cm, 63.0 ± 7.4 kg) and young adults who, 3-4 wk prior to testing, had tested positive for SARS-CoV-2 (SARS-CoV-2: 4 M/7 F, 20.2 ± 1.1 y, 172 ± 12 cm, 69.5 ± 12.4 kg) (means ± SD). Using Doppler ultrasound, brachial artery flow-mediated dilation (FMD) in the arm and single passive limb movement (sPLM) in the leg were assessed as markers of vascular function. Carotid-femoral pulse wave velocity (PWVcf) was asvsessed as a marker of arterial stiffness. FMD was lower in the SARS-CoV-2 group (2.71 ± 1.21%) compared with the control group (8.81 ± 2.96%) ( < 0.01) and when made relative to the shear stimulus (SARS-CoV-2: 0.04 ± 0.02 AU, control: 0.13 ± 0.06 AU, < 0.01). The femoral artery blood flow response, as evidenced by the area under the curve, from the sPLM was lower in the SARS-CoV-2 group (-3 ± 91 mL) compared with the control group (118 ± 114 mL) ( < 0.01). PWVcf was higher in the SARS-CoV-2 group (5.83 ± 0.62 m/s) compared with the control group (5.17 ± 0.66 m/s) ( < 0.01). Significantly lower systemic vascular function and higher arterial stiffness are evident weeks after testing positive for SARS-CoV-2 among young adults compared with controls. This study was the first to investigate the vascular implications of contracting SARS-CoV-2 among young, otherwise healthy adults. Using a cross-sectional design, this study assessed vascular function 3-4 wk after young adults tested positive for SARS-CoV-2. The main findings from this study were a strikingly lower vascular function and a higher arterial stiffness compared with healthy controls. Together, these results suggest rampant vascular effects seen weeks after contracting SARS-CoV-2 in young adults.

摘要

虽然 SARS-CoV-2 主要影响肺部,但该病毒可能通过血管紧张素转换酶 2 受体直接损害心血管系统,并引发全身炎症。持续的全身炎症可能会引发血管功能障碍,这是心血管疾病风险的早期迹象。为了确定 SARS-CoV-2 对四肢系统血管的潜在影响,我们对年轻健康成年人(对照组:5 名男性/15 名女性,23.0±1.3 岁,167±9cm,63.0±7.4kg)和在检测前 3-4 周检测出 SARS-CoV-2 阳性的年轻成年人(SARS-CoV-2 组:4 名男性/7 名女性,20.2±1.1 岁,172±12cm,69.5±12.4kg)进行了横断面分析。使用多普勒超声评估臂部肱动脉血流介导的扩张(FMD)和腿部单被动肢体运动(sPLM)作为血管功能的标志物。颈动脉-股动脉脉搏波速度(PWVcf)作为动脉僵硬度的标志物。与对照组(8.81±2.96%)相比,SARS-CoV-2 组的 FMD 较低(2.71±1.21%)( < 0.01),并且相对于剪切刺激(SARS-CoV-2:0.04±0.02AU,对照组:0.13±0.06AU)( < 0.01)。与对照组(118±114mL)相比,SARS-CoV-2 组的股动脉血流反应(由 sPLM 产生的曲线下面积)较低(-3±91mL)( < 0.01)。与对照组(5.17±0.66m/s)相比,SARS-CoV-2 组的 PWVcf 较高(5.83±0.62m/s)( < 0.01)。与对照组相比,SARS-CoV-2 组的系统性血管功能明显降低,动脉僵硬度明显升高。与对照组相比,在感染 SARS-CoV-2 后数周,年轻成年人的血管功能明显降低,动脉僵硬度明显升高。这项研究首次调查了在年轻、健康的成年人中感染 SARS-CoV-2 后的血管影响。本研究采用横断面设计,在感染 SARS-CoV-2 后 3-4 周评估血管功能。这项研究的主要发现是与健康对照组相比,血管功能明显降低,动脉僵硬度升高。这些结果表明,在年轻成年人感染 SARS-CoV-2 数周后,会出现广泛的血管效应。

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