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Long COVID impact on the cardiovascular function of aortic stenosis patients
Session:
Sessão de Posters 04 - Prognóstico e desfechos clínicos na estenose aórtica
Speaker:
Maria Inês Nuno Alves
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.7 Valvular Heart Disease - Other
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Maria Inês N Alves; Cláudia Mendes; Gustavo Couto; Inês Sousa; Juliana Morais; Alexandre Gonçalves; Carolina Silva; Diana Martins; Ana Beatriz Batista; João Abecasis; Adelino Leite Moreira; Inês Falcão Pires
Abstract
<p>Background: Long COVID (LC) affects a significant proportion of individuals after SARS-CoV-2 infection and may include cardiovascular complications. While mechanisms remain unclear, inflammation, RAAS dysregulation, and mitochondrial dysfunction are suspected contributors.<br /> <br /> Purpose: This study aimed to evaluate LC’s impact on cardiovascular function and related markers in aortic stenosis (AS) patients undergoing aortic valve replacement surgery.<br /> <br /> Methods: After informed consent, patients were stratified into three groups based on COVID-19 history prior to surgery: Control (never infected), no-LC (previous infection without persistent symptoms), and LC (ongoing symptoms). At surgery (T0), myocardial tissue, pericardial fluid, blood samples and echocardiographic data were collected, repeating blood tests/echocardiography at ~6 months post-surgery (T1). Analyses included histology, mitochondrial assessments, and inflammatory/RAAS biomarkers. The study was approved by the Ethics Committee of the involved hospitals and followed the Declaration of Helsinki.<br /> <br /> Results: Ninety-six patients (n=76 control, n=13 no-LC, and n=7 LC group) were enrolled, with comparable comorbidities and medications, except for lower rates of diabetes, hypertension, and β-blocker use in the no-LC group. Preoperative echocardiographic parameters were comparable between groups. Significant regression of left ventricular hypertrophy occurred exclusively in control patients. E/E’ tended to improve postoperatively (T1) in non-infected patients but increased in those with long COVID. Similarly, postoperative LVEF improvement approached significance only in patients without previous infection. Myocardial biopsies from LC patients revealed greater fibrosis and a trend toward larger cardiomyocytes compared to controls, whereas mitochondrial respiration and morphology showed no significant differences. Slightly reduced IL-6 suggested lower local inflammation, but decreased pericardial/serum STL2 (T0/T1) and elevated Serpin E2/PAI-1 indicated reduced cardioprotection in LC patients. Additionally, reduced serum angiotensin 1-7 at T1 implied diminished RAAS-mediated cardiac protection.<br /> <br /> Conclusions: Prior SARS-CoV-2 infection may hinder myocardial recovery following AVR, with LC promoting cardiac fibrosis and hypertrophy in AS patients, underscoring the need for further mechanistic investigation.</p>
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