TY  - JOUR
A1  - Kuchler, Timon
A1  - Günthner, Roman
A1  - Ribeiro, Andrea
A1  - Hausinger, Renate
A1  - Streese, Lukas
A1  - Wöhnl, Anna
A1  - Kesseler, Veronika
A1  - Negele, Johanna
A1  - Assali, Tarek
A1  - Carbajo-Lozoya, Javier
A1  - Lech, Maciej
A1  - Adorjan, Kristina
A1  - Stubbe, Hans Christian
A1  - Hanssen, Henner
A1  - Kotliar, Konstantin
A1  - Haller, Berhard
A1  - Heemann, Uwe
A1  - Schmaderer, Christoph
T1  - Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation
N2  - Background
Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians.

Methods
In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204).

Measurements and main results
PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42% ± 1.77% vs. 4.64% ± 2.59%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5–190.2] vs. 189.1 [179.4–197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8–0.9] vs. 0.88 [0.8–0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = − 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters.

Conclusion
Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management.
KW  - Endothelial dysfunction
KW  - Long COVID
KW  - Post-COVID-19 syndrome
KW  - retinal microvasculature
Y1  - 2023
U6  - http://dx.doi.org/10.1007/s10456-023-09885-6
N1  - Corresponding author: Christoph Schmaderer
VL  - 26
SP  - 547
EP  - 563
PB  - Springer Nature
CY  - Dordrecht
ER  - 
TY  - JOUR
A1  - Pressler, Axel
A1  - Esefeld, Katrin
A1  - Scherr, Johannes
A1  - Ali, Mohammad
A1  - Hanssen, Henner
A1  - Kotliar, Konstantin
A1  - Lanzl, Ines
A1  - Halle, Martin
A1  - Kaemmerer, Harald
A1  - Schmidt-Trucksäss, Arno
A1  - Hager, Alfred
T1  - Structural alterations of retinal arterioles in adults late after repair of aortic isthmic coarctation
JF  - The American Journal of Cardiology
N2  - Patients after coarctation repair still have an increased risk of cardiovascular or cerebrovascular events. This has been explained by the persisting hypertension and alterations in the peripheral vessels. However, involvement of the central vessels such as the retinal arteries is virtually unknown. A total of 34 patients after coarctation repair (22 men and 12 women; 23 to 58 years old, age range 0 to 32 years at surgical repair) and 34 nonhypertensive controls underwent structural and functional retinal vessel analysis. Using structural analysis, the vessel diameters were measured. Using functional analysis, the endothelium-dependent vessel dilation in response to flicker light stimulation was assessed. In the patients after coarctation repair, the retinal arteriolar diameter was significantly reduced compared to that of the controls (median 182 μm, first to third quartile 171 to 197; vs 197 μm, first to third quartile 193 to 206; p <0.001). These findings were independent of the peripheral blood pressure and age at intervention. No differences were found for venules. The functional analysis findings were not different between the patients and controls (maximum dilation 3.5%, first to third quartile 2.1% to 4.5% vs 3.6%, first to third quartile 2.2% to 4.3%; p = 0.81), indicating preserved autoregulative mechanisms. In conclusion, the retinal artery diameter is reduced in patients after coarctation repair, independent of their current blood pressure level and age at intervention. As a structural marker of chronic vessel damage associated with past, current, or future hypertension, retinal arteriolar narrowing has been linked to stroke incidence. These results indicate an involvement of cerebral microcirculation in aortic coarctation, despite timely repair, and might contribute to explain the increased rate of cerebrovascular events in such patients.
Y1  - 2010
U6  - http://dx.doi.org/10.1016/j.amjcard.2009.10.070
SN  - 0002-9149
VL  - 105
IS  - 5
SP  - 740
EP  - 744
PB  - Elsevier
CY  - Amsterdam
ER  -