Introduction & Objective: Diabetes and SARS-CoV-2 target the endothelium, causing microvascular dysfunction. We present a novel test to measure recovery dynamics of blood flow post-isometric exercise in the leg. We hypothesized that T2D related microvascular injury would augment perfusion abnormalities in people with COVID-19.
Methods: 14 hospitalized adults with COVID-19 and acute hypoxemia (7 with DM) underwent vPIVOT MRI on a 3T scanner 1 month post hospitalization. Scans were compared to 4 healthy controls (no DM or severe COVID-19). vPIVOT is an MRI sequence that simultaneously measures micro- and macrovascular blood flow and oxygenation, enabling quantification of integrated peripheral vascular responses to hyperemic stimuli, such as exercise. Here, the perfusion response following a 90s isometric plantar flexion contraction at 70% maximum effort was analyzed.
Results: Quantitative analysis of the MRI data was performed as shown (Figure). Significant between group differences of area under the curve (AUC, p=0.021) and time to recovery (TTR, p=0.024) were observed by ANOVA. Post-hoc comparisons did not detect any significant differences in COVID-19 participants with or without T2DM in this limited sample.
Conclusion: We demonstrate a novel MRI exam can elucidate total perfusion after exercise, and preliminary results show that it is reduced in time and in magnitude for people post severe COVID-19 infection.
E. Englund: None. A.J. Barker: None. G.I. Medrano: None. M. Cree-Green: Consultant; Pollie, Inc. Research Support; Amino Co. R. Maicki: None. I.S. Douglas: None. J.E.B. Reusch: Advisory Panel; Medtronic.
NIH (R01 DK130351); NIH/NCATS Colorado CTSA (KL2TR002534); American Heart Association (853697)
