ArticleAngiogenesis2023
Inflammation and vascular remodeling in COVID-19 hearts.
Article in Angiogenesis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 38 citations in OpenAlex.
- Comparative analysis of bypass vs. stent for coronary revascularization using an ex-vivo organ care system in an animal model.Scientific reports · 2026Article
- SARS-CoV-2-infected cardiomyocytes exhibit upregulated necroptosis, but no evidence of mitochondrial permeability transition.Journal of molecular and cellular cardiology plus · 2026Article
- Cardiac Tissue Damage in a Female Animal Post-COVID Model: Relevance of Chemokine-Mediated Inflammation.Viruses · 2025Article
- Differential expression of viral entry protein neuropilin 1 (NRP1) and neuropilin 2 (NRP2) in fatal COVID-19.Journal of virology · 2025Article
- The cellular dance that splits vessels.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Imputing single-cell protein abundance in multiplex tissue imaging.Nature communications · 2025Article
- Intussusceptive angiogenesis-on-a-chip: Evidence for transluminal vascular bridging by endothelial delamination.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Genetic and Epigenetic Intersections in COVID-19-Associated Cardiovascular Disease: Emerging Insights and Future Directions.Biomedicines · 2025Review
- New insights gained from cellular landscape changes in myocarditis and inflammatory cardiomyopathy.Heart failure reviews · 2024Review
- The role of vasculature and angiogenesis in respiratory diseases.Angiogenesis · 2024Review
- [Development and progress of the National Autopsy Network (NATON)].Pathologie (Heidelberg, Germany) · 2024Review
- Cardiac SARS-CoV-2 Infection, Involvement of Cytokines in Postmortem Immunohistochemical Study.Diagnostics (Basel, Switzerland) · 2024Article
- Fibrin-Based Hydrogels with Reactive Amphiphilic Copolymers for Mechanical Adjustments Allow for Capillary Formation in 2D and 3D Environments.Gels (Basel, Switzerland) · 2024Article
- Damage to endothelial barriers and its contribution to long COVID.Angiogenesis · 2024Review
- Medium- to long-term health condition of patients post-COVID-19, exercise intolerance and potential mechanisms: A narrative review and perspective.SAGE open medicine · 2024Review
- Correlation between epicardial adipose tissue and myocardial injury in patients with COVID-19.Frontiers in physiology · 2024Article
- Development of a novel machine learning model based on laboratory and imaging indices to predict acute cardiac injury in cancer patients with COVID-19 infection: a retrospective observational study.Journal of cancer research and clinical oncology · 2023Observational
- The modes of angiogenesis: an updated perspective.Angiogenesis · 2023Article
- Vascular Dysfunctions Contribute to the Long-Term Cognitive Deficits Following COVID-19.Biology · 2023Review
- Multi-omic longitudinal study reveals immune correlates of clinical course among hospitalized COVID-19 patients.Cell reports. Medicine · 2023Article
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Authors and funding
29 authors at 12 institutions in 5 countries.
Funding
Abstract
A wide range of cardiac symptoms have been observed in COVID-19 patients, often significantly influencing the clinical outcome. While the pathophysiology of pulmonary COVID-19 manifestation has been substantially unraveled, the underlying pathomechanisms of cardiac involvement in COVID-19 are largely unknown. In this multicentre study, we performed a comprehensive analysis of heart samples from 24 autopsies with confirmed SARS-CoV-2 infection and compared them to samples of age-matched Influenza H1N1 A (n = 16), lymphocytic non-influenza myocarditis cases (n = 8), and non-inflamed heart tissue (n = 9). We employed conventional histopathology, multiplexed immunohistochemistry (MPX), microvascular corrosion casting, scanning electron microscopy, X-ray phase-contrast tomography using synchrotron radiation, and direct multiplexed measurements of gene expression, to assess morphological and molecular changes holistically. Based on histopathology, none of the COVID-19 samples fulfilled the established diagnostic criteria of viral myocarditis. However, quantification via MPX showed a significant increase in perivascular CD11b/TIE2 + -macrophages in COVID-19 over time, which was not observed in influenza or non-SARS-CoV-2 viral myocarditis patients. Ultrastructurally, a significant increase in intussusceptive angiogenesis as well as multifocal thrombi, inapparent in conventional morphological analysis, could be demonstrated. In line with this, on a molecular level, COVID-19 hearts displayed a distinct expression pattern of genes primarily coding for factors involved in angiogenesis and epithelial-mesenchymal transition (EMT), changes not seen in any of the other patient groups. We conclude that cardiac involvement in COVID-19 is an angiocentric macrophage-driven inflammatory process, distinct from classical anti-viral inflammatory responses, and substantially underappreciated by conventional histopathologic analysis. For the first time, we have observed intussusceptive angiogenesis in cardiac tissue, which we previously identified as the linchpin of vascular remodeling in COVID-19 pneumonia, as a pathognomic sign in affected hearts. Moreover, we identified CD11b + /TIE2 + macrophages as the drivers of intussusceptive angiogenesis and set forward a putative model for the molecular regulation of vascular alterations.
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