The international CARTESIAN study confirms: A Covid-19 infection can measurably age the blood vessels – even after mild cases. Women are particularly affected. Experts from the AIT Austrian Institute of Technology are represented on the scientific committee, contributing their long-standing experience in pulse wave analysis as well as their role in the European network VascAgeNet.
Accelerated vascular ageing after infection
The CARTESIAN study (Covid-19 effects on ARTErial StIffness and vascular AgeiNg), published in the European Heart Journal, examined data from 2,390 people in 16 countries. Six months after infection, all Covid-19 groups – from mild cases to those requiring intensive care – showed increased arterial stiffness. The effect was particularly pronounced in women: even after mild infections, the change corresponded to around five years of vascular ageing. “Through international networking in the COST Action VascAgeNet, we were able to recruit clinical centres worldwide for the study within a very short time, even though the main focus of the clinical partners at that time was on the acute treatment of their Covid-19 patients,” emphasises Christopher Mayer, Medical Signal Analysis Team, AIT Center for Health & Bioresources.
Methodology and AIT contribution
The researchers used measurement of pulse wave velocity (PWV), the internationally recognised gold standard for arterial stiffness. AIT has been working for years on improving these methods – for example with algorithms for signal processing and their use in clinical practice.
The CARTESIAN study was initiated by the Artery Society together with the European research network VascAgeNet. AIT researchers are closely involved in both structures: Christopher Mayer was coordinator of the COST Action VascAgeNet and Bernhard Hametner a member of the Executive Committee of the Artery Society. Both are part of the CARTESIAN scientific committee. “We were able to contribute our expertise in pulse wave analysis and our contacts with manufacturers of devices for non-invasive measurement of vascular ageing to the study design thanks to my role in the professional society. Interdisciplinary collaboration made it possible to respond quickly to the special circumstances and to initiate the international study,” explains Bernhard Hametner.
Women particularly affected – possible causes
The data show that women are significantly more affected than men. One possible explanation lies in the different immune responses: women develop a faster and more robust defence, which provides short-term protection but can lead to greater vascular damage in the long term. There was also a striking correlation with long Covid symptoms such as chronic fatigue or shortness of breath, which were particularly common in female patients with increased vascular stiffness.
Partially reversible, but clinically relevant
A positive finding emerged from the twelve-month follow-up: while the control group showed age-related deterioration over the same period, vascular values in many Covid-19 patients stabilised or even improved slightly. Vaccinations also proved to be a protective factor, as vaccinated individuals showed lower PWV values on average. Despite this positive trend, the clinical relevance remains high: even small changes in vascular stiffness increase the risk of cardiovascular disease. In future, the CARTESIAN study participants will continue to be monitored to determine whether accelerated vascular ageing actually leads to a higher risk of heart attack and stroke.
The results clearly show that Covid-19 has effects far beyond the acute infection. For AIT, participation in CARTESIAN confirms the strategic importance of pulse wave analysis and close cooperation in international networks. In this way, AIT experts make a significant contribution to scientifically understanding the long-term consequences of Covid-19 – and to providing the basis for preventive measures in healthcare.