Tags

Type your tag names separated by a space and hit enter

Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging.
JACC Cardiovasc Imaging. 2020 11; 13(11):2330-2339.JC

Abstract

Objectives

This study evaluated cardiac involvement in patients recovered from coronavirus disease-2019 (COVID-19) using cardiac magnetic resonance (CMR).

Background

Myocardial injury caused by COVID-19 was previously reported in hospitalized patients. It is unknown if there is sustained cardiac involvement after patients' recovery from COVID-19.

Methods

Twenty-six patients recovered from COVID-19 who reported cardiac symptoms and underwent CMR examinations were retrospectively included. CMR protocols consisted of conventional sequences (cine, T2-weighted imaging, and late gadolinium enhancement [LGE]) and quantitative mapping sequences (T1, T2, and extracellular volume [ECV] mapping). Edema ratio and LGE were assessed in post-COVID-19 patients. Cardiac function, native T1/T2, and ECV were quantitatively evaluated and compared with controls.

Results

Fifteen patients (58%) had abnormal CMR findings on conventional CMR sequences: myocardial edema was found in 14 (54%) patients and LGE was found in 8 (31%) patients. Decreased right ventricle functional parameters including ejection fraction, cardiac index, and stroke volume/body surface area were found in patients with positive conventional CMR findings. Using quantitative mapping, global native T1, T2, and ECV were all found to be significantly elevated in patients with positive conventional CMR findings, compared with patients without positive findings and controls (median [interquartile range]: native T1 1,271 ms [1,243 to 1,298 ms] vs. 1,237 ms [1,216 to 1,262 ms] vs. 1,224 ms [1,217 to 1,245 ms]; mean ± SD: T2 42.7 ± 3.1 ms vs. 38.1 ms ± 2.4 vs. 39.1 ms ± 3.1; median [interquartile range]: 28.2% [24.8% to 36.2%] vs. 24.8% [23.1% to 25.4%] vs. 23.7% [22.2% to 25.2%]; p = 0.002; p < 0.001, and p = 0.002, respectively).

Conclusions

Cardiac involvement was found in a proportion of patients recovered from COVID-19. CMR manifestation included myocardial edema, fibrosis, and impaired right ventricle function. Attention should be paid to the possible myocardial involvement in patients recovered from COVID-19 with cardiac symptoms.

Authors+Show Affiliations

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Radiology, Wuhan No.1 Hospital, Wuhan, China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: zenghs@tjh.tjmu.edu.cn.Division of Imaging Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: q.tao@lumc.nl.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: lmxia@tjh.tjmu.edu.cn.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32763118

Citation

Huang, Lu, et al. "Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging." JACC. Cardiovascular Imaging, vol. 13, no. 11, 2020, pp. 2330-2339.
Huang L, Zhao P, Tang D, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC Cardiovasc Imaging. 2020;13(11):2330-2339.
Huang, L., Zhao, P., Tang, D., Zhu, T., Han, R., Zhan, C., Liu, W., Zeng, H., Tao, Q., & Xia, L. (2020). Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC. Cardiovascular Imaging, 13(11), 2330-2339. https://doi.org/10.1016/j.jcmg.2020.05.004
Huang L, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC Cardiovasc Imaging. 2020;13(11):2330-2339. PubMed PMID: 32763118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. AU - Huang,Lu, AU - Zhao,Peijun, AU - Tang,Dazhong, AU - Zhu,Tong, AU - Han,Rui, AU - Zhan,Chenao, AU - Liu,Weiyong, AU - Zeng,Hesong, AU - Tao,Qian, AU - Xia,Liming, Y1 - 2020/05/12/ PY - 2020/04/17/received PY - 2020/04/30/revised PY - 2020/05/04/accepted PY - 2020/8/9/pubmed PY - 2020/11/20/medline PY - 2020/8/9/entrez KW - ACE2, angiotensin-converting enzyme 2 KW - AHA, American Heart Association KW - BSA, body surface area KW - CI, cardiac index KW - CMR, cardiac magnetic resonance KW - CO, cardiac output KW - COVID-19, coronavirus disease-2019 KW - ECV, extracellular volume KW - EDV, end-diastolic volume KW - EF, ejection fraction KW - ER, edema ratio KW - ESV, end-systolic volume KW - FA, flip angle KW - FOV, field of view KW - IQR, interquartile range KW - LGE, late gadolinium enhancement KW - LV, left ventricle KW - LVEF, left ventricular ejection fraction KW - PSIR, phase-sensitive inversion-recovery KW - RT-PCR, reverse transcription and polymerase chain reaction KW - RV, right ventricle KW - RVEF, right ventricular ejection fraction KW - SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2 KW - SI, signal intensity KW - SSFP, steady state free precession KW - STIR, short tau inversion recovery KW - SV, stroke volume KW - T2WI, T2-weighted imaging KW - TE, echo time KW - TR, repetition time KW - cardiac involvement KW - cardiac magnetic resonance imaging KW - coronavirus disease-2019 KW - hs-cTnI, high-sensitive cardiac troponin I SP - 2330 EP - 2339 JF - JACC. Cardiovascular imaging JO - JACC Cardiovasc Imaging VL - 13 IS - 11 N2 - Objectives: This study evaluated cardiac involvement in patients recovered from coronavirus disease-2019 (COVID-19) using cardiac magnetic resonance (CMR). Background: Myocardial injury caused by COVID-19 was previously reported in hospitalized patients. It is unknown if there is sustained cardiac involvement after patients' recovery from COVID-19. Methods: Twenty-six patients recovered from COVID-19 who reported cardiac symptoms and underwent CMR examinations were retrospectively included. CMR protocols consisted of conventional sequences (cine, T2-weighted imaging, and late gadolinium enhancement [LGE]) and quantitative mapping sequences (T1, T2, and extracellular volume [ECV] mapping). Edema ratio and LGE were assessed in post-COVID-19 patients. Cardiac function, native T1/T2, and ECV were quantitatively evaluated and compared with controls. Results: Fifteen patients (58%) had abnormal CMR findings on conventional CMR sequences: myocardial edema was found in 14 (54%) patients and LGE was found in 8 (31%) patients. Decreased right ventricle functional parameters including ejection fraction, cardiac index, and stroke volume/body surface area were found in patients with positive conventional CMR findings. Using quantitative mapping, global native T1, T2, and ECV were all found to be significantly elevated in patients with positive conventional CMR findings, compared with patients without positive findings and controls (median [interquartile range]: native T1 1,271 ms [1,243 to 1,298 ms] vs. 1,237 ms [1,216 to 1,262 ms] vs. 1,224 ms [1,217 to 1,245 ms]; mean ± SD: T2 42.7 ± 3.1 ms vs. 38.1 ms ± 2.4 vs. 39.1 ms ± 3.1; median [interquartile range]: 28.2% [24.8% to 36.2%] vs. 24.8% [23.1% to 25.4%] vs. 23.7% [22.2% to 25.2%]; p = 0.002; p < 0.001, and p = 0.002, respectively). Conclusions: Cardiac involvement was found in a proportion of patients recovered from COVID-19. CMR manifestation included myocardial edema, fibrosis, and impaired right ventricle function. Attention should be paid to the possible myocardial involvement in patients recovered from COVID-19 with cardiac symptoms. SN - 1876-7591 UR - https://www.unboundmedicine.com/medline/citation/32763118/Cardiac_Involvement_in_Patients_Recovered_From_COVID_2019_Identified_Using_Magnetic_Resonance_Imaging_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1936-878X(20)30403-4 DB - PRIME DP - Unbound Medicine ER -