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J Clin Med
. 2024 Dec 2;13(23):7317.
doi: 10.3390/jcm13237317. Immune Profile and MRI-Detected Cardiac Fibrosis and Edema in Hypertensive and Non-Hypertensive Patients with COVID-19
Renata Moll-Bernardes 1 , Gabriel C Camargo 1 , Andréa Silvestre-Sousa 1 2 , Julia Machado Barroso 1 , Juliana R Ferreira 1 3 , Mariana B Tortelly 1 3 , Adriana L Pimentel 1 3 , Ana Cristina B S Figueiredo 1 3 , Eduardo B Schaustz 1 , José Carlos P Secco 1 , Sergio C Fortier 1 , Narendra Vera 4 , Luciana Conde 4 , Mauro Jorge Cabral-Castro 5 6 , Denilson C Albuquerque 1 7 , Paulo H Rosado-de-Castro 1 , Martha V T Pinheiro 1 3 , Olga F Souza 1 3 , Ronir R Luiz 1 8 , Emiliano Medei 1 9
Affiliations
Cardiac involvement in 2019 coronavirus disease (COVID-19) survivors has been reported frequently. An exacerbated immune response may be the main mechanism of myocardial injury and late cardiac sequelae in this population. Background/Objectives: We investigated the immune profile in hypertensive and non-hypertensive patients with COVID-19 who developed late cardiac fibrosis and edema, as detected by magnetic resonance imaging (MRI). Methods: We evaluated associations of cytokine and immune-cell subset levels during hospitalization for COVID-19 with the presence of myocardial interstitial fibrosis [represented by the extracellular volume (ECV)] or edema (represented by the T2), detected by cardiac MRI examination after discharge, in hypertensive and non-hypertensive patients. Results: Patients with hypertension had reduced B-cell percentages, increased natural killer cell percentages, and higher interleukin (IL)-4, IL-5, IL-13, IL-17A, and tumor necrosis factor-β levels compared to patients without hypertension. Larger percentages of human leukocyte antigen DR isotope+ blood cells, reflecting CD8+ T-cell activation, correlated with increased T2 and ECV in hypertensive patients. The HLA-DR mean fluorescence intensity was associated with ECV in non-hypertensive patients. Conclusions: Our findings reveal cytokine and immune-cell dysregulation in both hypertensive and non-hypertensive patients with COVID-19, along with moderate correlations between CD8+ T-cell activation and increased cardiac MRI markers of myocardial interstitial fibrosis and edema. These results contribute to a deeper understanding of immune dysfunction mechanisms involved in myocardial remodeling.
Keywords: CD8+; COVID-19; T2; extracellular volume; hypertension; immune system; myocardial fibrosis.
. 2024 Dec 2;13(23):7317.
doi: 10.3390/jcm13237317. Immune Profile and MRI-Detected Cardiac Fibrosis and Edema in Hypertensive and Non-Hypertensive Patients with COVID-19
Renata Moll-Bernardes 1 , Gabriel C Camargo 1 , Andréa Silvestre-Sousa 1 2 , Julia Machado Barroso 1 , Juliana R Ferreira 1 3 , Mariana B Tortelly 1 3 , Adriana L Pimentel 1 3 , Ana Cristina B S Figueiredo 1 3 , Eduardo B Schaustz 1 , José Carlos P Secco 1 , Sergio C Fortier 1 , Narendra Vera 4 , Luciana Conde 4 , Mauro Jorge Cabral-Castro 5 6 , Denilson C Albuquerque 1 7 , Paulo H Rosado-de-Castro 1 , Martha V T Pinheiro 1 3 , Olga F Souza 1 3 , Ronir R Luiz 1 8 , Emiliano Medei 1 9
Affiliations
- PMID: 39685774
- PMCID: PMC11642154
- DOI: 10.3390/jcm13237317
Cardiac involvement in 2019 coronavirus disease (COVID-19) survivors has been reported frequently. An exacerbated immune response may be the main mechanism of myocardial injury and late cardiac sequelae in this population. Background/Objectives: We investigated the immune profile in hypertensive and non-hypertensive patients with COVID-19 who developed late cardiac fibrosis and edema, as detected by magnetic resonance imaging (MRI). Methods: We evaluated associations of cytokine and immune-cell subset levels during hospitalization for COVID-19 with the presence of myocardial interstitial fibrosis [represented by the extracellular volume (ECV)] or edema (represented by the T2), detected by cardiac MRI examination after discharge, in hypertensive and non-hypertensive patients. Results: Patients with hypertension had reduced B-cell percentages, increased natural killer cell percentages, and higher interleukin (IL)-4, IL-5, IL-13, IL-17A, and tumor necrosis factor-β levels compared to patients without hypertension. Larger percentages of human leukocyte antigen DR isotope+ blood cells, reflecting CD8+ T-cell activation, correlated with increased T2 and ECV in hypertensive patients. The HLA-DR mean fluorescence intensity was associated with ECV in non-hypertensive patients. Conclusions: Our findings reveal cytokine and immune-cell dysregulation in both hypertensive and non-hypertensive patients with COVID-19, along with moderate correlations between CD8+ T-cell activation and increased cardiac MRI markers of myocardial interstitial fibrosis and edema. These results contribute to a deeper understanding of immune dysfunction mechanisms involved in myocardial remodeling.
Keywords: CD8+; COVID-19; T2; extracellular volume; hypertension; immune system; myocardial fibrosis.