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Cardiovascular autonomic dysfunction in post-COVID-19 syndrome : a major health-care burden

Fedorowski, Artur LU orcid ; Fanciulli, Alessandra ; Raj, Satish R ; Sheldon, Robert ; Shibao, Cyndya A and Sutton, Richard LU (2024) In Nature Reviews Cardiology
Abstract

Cardiovascular autonomic dysfunction (CVAD) is a malfunction of the cardiovascular system caused by deranged autonomic control of circulatory homeostasis. CVAD is an important component of post-COVID-19 syndrome, also termed long COVID, and might affect one-third of highly symptomatic patients with COVID-19. The effects of CVAD can be seen at both the whole-body level, with impairment of heart rate and blood pressure control, and in specific body regions, typically manifesting as microvascular dysfunction. Many severely affected patients with long COVID meet the diagnostic criteria for two common presentations of CVAD: postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. CVAD can also manifest as disorders... (More)

Cardiovascular autonomic dysfunction (CVAD) is a malfunction of the cardiovascular system caused by deranged autonomic control of circulatory homeostasis. CVAD is an important component of post-COVID-19 syndrome, also termed long COVID, and might affect one-third of highly symptomatic patients with COVID-19. The effects of CVAD can be seen at both the whole-body level, with impairment of heart rate and blood pressure control, and in specific body regions, typically manifesting as microvascular dysfunction. Many severely affected patients with long COVID meet the diagnostic criteria for two common presentations of CVAD: postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. CVAD can also manifest as disorders associated with hypotension, such as orthostatic or postprandial hypotension, and recurrent reflex syncope. Advances in research, accelerated by the COVID-19 pandemic, have identified new potential pathophysiological mechanisms, diagnostic methods and therapeutic targets in CVAD. For clinicians who daily see patients with CVAD, knowledge of its symptomatology, detection and appropriate management is more important than ever. In this Review, we define CVAD and its major forms that are encountered in post-COVID-19 syndrome, describe possible CVAD aetiologies, and discuss how CVAD, as a component of post-COVID-19 syndrome, can be diagnosed and managed. Moreover, we outline directions for future research to discover more efficient ways to cope with this prevalent and long-lasting condition.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Nature Reviews Cardiology
publisher
Nature Publishing Group
external identifiers
  • scopus:85180991435
  • pmid:38163814
ISSN
1759-5002
DOI
10.1038/s41569-023-00962-3
language
English
LU publication?
yes
additional info
© 2024. Springer Nature Limited.
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c3275015-528c-49f3-8e86-ed45d86c5293
date added to LUP
2024-01-08 10:41:07
date last changed
2024-04-24 00:54:41
@article{c3275015-528c-49f3-8e86-ed45d86c5293,
  abstract     = {{<p>Cardiovascular autonomic dysfunction (CVAD) is a malfunction of the cardiovascular system caused by deranged autonomic control of circulatory homeostasis. CVAD is an important component of post-COVID-19 syndrome, also termed long COVID, and might affect one-third of highly symptomatic patients with COVID-19. The effects of CVAD can be seen at both the whole-body level, with impairment of heart rate and blood pressure control, and in specific body regions, typically manifesting as microvascular dysfunction. Many severely affected patients with long COVID meet the diagnostic criteria for two common presentations of CVAD: postural orthostatic tachycardia syndrome and inappropriate sinus tachycardia. CVAD can also manifest as disorders associated with hypotension, such as orthostatic or postprandial hypotension, and recurrent reflex syncope. Advances in research, accelerated by the COVID-19 pandemic, have identified new potential pathophysiological mechanisms, diagnostic methods and therapeutic targets in CVAD. For clinicians who daily see patients with CVAD, knowledge of its symptomatology, detection and appropriate management is more important than ever. In this Review, we define CVAD and its major forms that are encountered in post-COVID-19 syndrome, describe possible CVAD aetiologies, and discuss how CVAD, as a component of post-COVID-19 syndrome, can be diagnosed and managed. Moreover, we outline directions for future research to discover more efficient ways to cope with this prevalent and long-lasting condition.</p>}},
  author       = {{Fedorowski, Artur and Fanciulli, Alessandra and Raj, Satish R and Sheldon, Robert and Shibao, Cyndya A and Sutton, Richard}},
  issn         = {{1759-5002}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Nature Reviews Cardiology}},
  title        = {{Cardiovascular autonomic dysfunction in post-COVID-19 syndrome : a major health-care burden}},
  url          = {{http://dx.doi.org/10.1038/s41569-023-00962-3}},
  doi          = {{10.1038/s41569-023-00962-3}},
  year         = {{2024}},
}