Increasing numbers of confirmed cases and mortality rates of coronavirus disease 2019 (COVID-19) are occurring in several countries and continents. Information regarding the impact of cardiovascular complication on fatal outcome is scarce.OBJECTIVE To evaluate the association of underlying cardiovascular disease (CVD) and myocardial injury with fatal outcomes in patients with COVID-19.

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Hypoxia/reoxygenation (H/R)‐induced myocardial cell injury is the main cause of acute myocardial infarction (AMI). Many proofs show that circular RNA plays an important role in the development of AMI. The purpose of this study was to investigate the role of circSAMD4A in H/R‐induced myocardial injury. The levels of circular SAMD4A (circSAMD4A) were detected in the heart tissues of AMI mice and H/R‐induced H9C2 cells, and the circSAMD4A was suppressed in AMI mice and H/R‐induced H9C2 cells to investigate its’ function in AMI. The levels of circSAMD4A and miR‐138‐5p were detected by real‐time quantitative PCR, and MTT assay was used to detect cell viability. TUNEL analysis and Annexin V‐FITC were used to determine apoptosis. The expression of Bcl‐2 and Bax proteins was detected by Western blot. IL‐1β, TNF‐α and IL‐6 were detected by ELISA kits. The study found that the levels of circSAMD4A were up‐regulated after H/R induction and inhibition of circSAMD4A expression would reduce the H/R‐induced apoptosis and inflammation. MiR‐138‐5p was down‐regulated in H/R‐induced H9C2 cells. circSAMD4A was a targeted regulator of miR‐138‐5p. CircSAMD4A inhibited the expression of miR‐138‐5p to promote H/R‐induced myocardial cell injury in vitro and vivo. In conclusion, CircSAMD4A can sponge miR‐138‐5p to promote H/R‐induced apoptosis and inflammatory response.

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(1) Background: In spite of the undeniable clinical value of the index of microvascular resistance (IMR) in assessing the status of coronary microcirculation, its use globally remains very low. The aim of this study was to validate the novel single-view, pressure-wire- and adenosine-free angiographic microvascular resistance (AMR) index, having the invasive wire-based IMR as a reference standard. (2) Methods: one hundred and sixty-three patients (257 vessels) were investigated with pressure wire-based IMR. Microvascular dysfunction (CMD) was defined by IMR ≥ 25. AMR was independently computed from the diagnostic coronary angiography in a blinded fashion. (3) Results: AMR demonstrated a good correlation (r = 0.83, p < 0.001) and diagnostic performance (AUC 0.94; 95% CI: 0.91 to 0.97) compared with wire-based IMR. The best cutoff value for AMR in determining IMR ≥ 25 was 2.5 mmHg*s/cm. The overall diagnostic accuracy of AMR was 87.2% (95% CI: 83.0% to 91.3%), with a sensitivity of 93.5% (95% CI: 87.0% to 97.3%), a specificity of 82.7% (95% CI: 75.6% to 88.4%), a positive predictive value of 79.4% (95% CI: 71.2% to 86.1%) and a negative predictive value of 94.7% (95% CI: 89.3% to 97.8%). No difference in terms of CMD rate was described among different clinical presentations. (4) Conclusions: AMR derived solely from a single angiographic view is a feasible computational alternative to pressure wire-based IMR, with good diagnostic accuracy in assessing CMD.