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Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging

Lu Huang1, Peijun Zhao1, Dazhong Tang1

  • 1Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

JACC. Cardiovascular Imaging
|August 9, 2020
PubMed

Insights

Persistent cardiac involvement, including myocardial edema and fibrosis, was detected in recovered COVID-19 patients using cardiac magnetic resonance (CMR). This highlights the need for cardiac monitoring in post-COVID-19 individuals experiencing symptoms.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Myocardial injury is a known complication of COVID-19 in hospitalized patients.
  • Sustained cardiac involvement after recovery from COVID-19 remains largely unknown.
  • This study investigates long-term cardiac effects in recovered COVID-19 patients.

Purpose of the Study:

  • To evaluate cardiac involvement in patients after recovery from COVID-19.
  • To assess myocardial edema, fibrosis, and ventricular function using cardiac magnetic resonance (CMR).
  • To compare quantitative mapping parameters in post-COVID-19 patients with controls.

Main Methods:

  • Retrospective analysis of 26 COVID-19 recovered patients with cardiac symptoms who underwent CMR.
  • CMR protocols included conventional sequences (cine, T2-weighted imaging, late gadolinium enhancement [LGE]) and quantitative mapping (T1, T2, extracellular volume [ECV]).
  • Assessment of myocardial edema, LGE, cardiac function, and quantitative mapping parameters, compared to controls.

Main Results:

  • Abnormal CMR findings were present in 58% of patients.
  • Myocardial edema (54%) and LGE (31%) were observed.
  • Elevated global native T1, T2, and ECV values were significantly higher in patients with positive CMR findings compared to controls (p<0.01).

Conclusions:

  • Cardiac involvement is present in a significant proportion of COVID-19 recovered patients.
  • CMR revealed myocardial edema, fibrosis, and impaired right ventricle function.
  • Patients with cardiac symptoms post-COVID-19 require attention for potential myocardial involvement.
Abstract

Keywords:
ACE2, angiotensin-converting enzyme 2AHA, American Heart AssociationBSA, body surface areaCI, cardiac indexCMR, cardiac magnetic resonanceCO, cardiac outputCOVID-19, coronavirus disease-2019ECV, extracellular volumeEDV, end-diastolic volumeEF, ejection fractionER, edema ratioESV, end-systolic volumeFA, flip angleFOV, field of viewIQR, interquartile rangeLGE, late gadolinium enhancementLV, left ventricleLVEF, left ventricular ejection fractionPSIR, phase-sensitive inversion-recoveryRT-PCR, reverse transcription and polymerase chain reactionRV, right ventricleRVEF, right ventricular ejection fractionSARS-CoV-2, severe acute respiratory syndrome-coronavirus-2SI, signal intensitySSFP, steady state free precessionSTIR, short tau inversion recoverySV, stroke volumeT2WI, T2-weighted imagingTE, echo timeTR, repetition timecardiac involvementcardiac magnetic resonance imagingcoronavirus disease-2019hs-cTnI, high-sensitive cardiac troponin I

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