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Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19.
PLoS One. 2023; 18(3):e0282394.Plos

Abstract

BACKGROUND

Long-term symptoms are frequent after coronavirus disease 2019 (COVID-19). We studied the prevalence of post-acute myocardial scar on cardiac magnetic resonance imaging (CMR) in patients hospitalized due to COVID-19 and its association with long-term symptoms.

MATERIALS AND METHODS

In this prospective observational single-center study, 95 formerly hospitalized COVID-19 patients underwent CMR imaging at the median of 9 months after acute COVID-19. In addition, 43 control subjects were imaged. Myocardial scar characteristic of myocardial infarction or myocarditis were noted from late gadolinium enhancement images (LGE). Patient symptoms were screened using a questionnaire. Data are presented as mean ± standard deviation or median (interquartile range).

RESULTS

The presence of any LGE was higher in COVID-19 patients (66% vs. 37%, p<0.01) as was the presence of LGE suggestive of previous myocarditis (29% vs. 9%, p = 0.01). The prevalence of ischemic scar was comparable (8% vs. 2%, p = 0.13). Only two COVID-19 patients (7%) had myocarditis scar combined with left ventricular dysfunction (EF <50%). Myocardial edema was not detected in any participant. The need for intensive care unit (ICU) treatment during initial hospitalization was comparable in patients with and without myocarditis scar (47% vs. 67%, p = 0.44). Dyspnea, chest pain, and arrhythmias were prevalent in COVID-19 patients at follow-up (64%, 31%, and 41%, respectively) but not associated with myocarditis scar on CMR.

CONCLUSIONS

Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation.

Links

Authors+Show Affiliations

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Clinical Physiology and Nuclear Medicine, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Radiology, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Department of Anesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.

MeSH

HumansMyocarditisContrast MediaCicatrixVentricular Function, LeftCOVID-19GadoliniumMagnetic Resonance ImagingMagnetic Resonance SpectroscopyHeart InjuriesMagnetic Resonance Imaging, CinePredictive Value of Tests

Pub Type(s)

Observational Study

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36888600

Citation

Yar, Aria, et al. "Cardiac Magnetic Resonance -detected Myocardial Injury Is Not Associated With Long-term Symptoms in Patients Hospitalized Due to COVID-19." PloS One, vol. 18, no. 3, 2023, pp. e0282394.

Yar A, Uusitalo V, Vaara SM, et al. Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19. PLoS One. 2023;18(3):e0282394.

Yar, A., Uusitalo, V., Vaara, S. M., Holmström, M., Vuorinen, A. M., Heliö, T., Paakkanen, R., Kivistö, S., Syväranta, S., & Hästbacka, J. (2023). Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19. PloS One, 18(3), e0282394. https://doi.org/10.1371/journal.pone.0282394

Yar A, et al. Cardiac Magnetic Resonance -detected Myocardial Injury Is Not Associated With Long-term Symptoms in Patients Hospitalized Due to COVID-19. PLoS One. 2023;18(3):e0282394. PubMed PMID: 36888600.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19. AU - Yar,Aria, AU - Uusitalo,Valtteri, AU - Vaara,Satu M, AU - Holmström,Miia, AU - Vuorinen,Aino-Maija, AU - Heliö,Tiina, AU - Paakkanen,Riitta, AU - Kivistö,Sari, AU - Syväranta,Suvi, AU - Hästbacka,Johanna, Y1 - 2023/03/08/ PY - 2022/10/09/received PY - 2023/02/03/accepted PY - 2023/3/8/entrez PY - 2023/3/9/pubmed PY - 2023/3/11/medline SP - e0282394 EP - e0282394 JF - PloS one JO - PLoS One VL - 18 IS - 3 N2 - BACKGROUND: Long-term symptoms are frequent after coronavirus disease 2019 (COVID-19). We studied the prevalence of post-acute myocardial scar on cardiac magnetic resonance imaging (CMR) in patients hospitalized due to COVID-19 and its association with long-term symptoms. MATERIALS AND METHODS: In this prospective observational single-center study, 95 formerly hospitalized COVID-19 patients underwent CMR imaging at the median of 9 months after acute COVID-19. In addition, 43 control subjects were imaged. Myocardial scar characteristic of myocardial infarction or myocarditis were noted from late gadolinium enhancement images (LGE). Patient symptoms were screened using a questionnaire. Data are presented as mean ± standard deviation or median (interquartile range). RESULTS: The presence of any LGE was higher in COVID-19 patients (66% vs. 37%, p<0.01) as was the presence of LGE suggestive of previous myocarditis (29% vs. 9%, p = 0.01). The prevalence of ischemic scar was comparable (8% vs. 2%, p = 0.13). Only two COVID-19 patients (7%) had myocarditis scar combined with left ventricular dysfunction (EF <50%). Myocardial edema was not detected in any participant. The need for intensive care unit (ICU) treatment during initial hospitalization was comparable in patients with and without myocarditis scar (47% vs. 67%, p = 0.44). Dyspnea, chest pain, and arrhythmias were prevalent in COVID-19 patients at follow-up (64%, 31%, and 41%, respectively) but not associated with myocarditis scar on CMR. CONCLUSIONS: Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/36888600/Cardiac_magnetic_resonance__detected_myocardial_injury_is_not_associated_with_long_term_symptoms_in_patients_hospitalized_due_to_COVID_19_ DB - PRIME DP - Unbound Medicine ER -