Imaging Cardiovascular Inflammation in the COVID-19 Era
Andras Mester1, Imre Benedek1, Nora Rat1
1Department of Cardiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Târgu Mureș, Romania.
Insights
COVID-19 frequently causes cardiac complications, increasing mortality risk, especially in those with pre-existing cardiovascular disease. Advanced imaging like cardiac magnetic resonance (CMR) and AI aids in diagnosing and managing these heart issues.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- COVID-19 is linked to significant cardiac complications and high mortality rates.
- Patients with cardiovascular disease and SARS-CoV-2 infection face increased risks of intensive care admission and death.
- Myocardial injury mechanisms involve inflammation, plaque instability, thrombosis, and ischemia.
Purpose of the Study:
- To review current knowledge on imaging modalities for COVID-related myocardial inflammation.
- To discuss the role of cardiac magnetic resonance (CMR) and computed tomography in evaluating cardiovascular complications.
- To explore the potential of artificial intelligence in improving diagnostic accuracy and prognosis.
Main Methods:
- Review of current literature on imaging techniques for COVID-19 cardiac manifestations.
- Focus on cardiac magnetic resonance (CMR) and multimodal imaging protocols.
- Inclusion of artificial intelligence applications in diagnostic interpretation.
Main Results:
- Cardiac magnetic resonance (CMR) is the preferred non-invasive method for detecting myocardial injury.
- Multimodal imaging, including CMR and CT, offers comprehensive evaluation of cardiorespiratory complications.
- AI can enhance diagnostic accuracy, risk stratification, and prognosis assessment.
Conclusions:
- Imaging plays a crucial role in identifying and managing COVID-19-related cardiac issues.
- Multimodal imaging combined with biological markers guides therapeutic strategies.
- AI integration promises improved patient outcomes through enhanced diagnostics.
Abstract:
Cardiac complications are among the most frequent extrapulmonary manifestations of COVID-19 and are associated with high mortality rates. Moreover, positive SARS-CoV-2 patients with underlying cardiovascular disease are more likely to require intensive care and are at higher risk of death. The underlying mechanism for myocardial injury is multifaceted, in which the severe inflammatory response causes myocardial inflammation, coronary plaque destabilization, acute thrombotic events, and ischemia. Cardiac magnetic resonance (CMR) imaging is the non-invasive method of choice for identifying myocardial injury, and it is able to differentiate between underlying causes in various and often challenging clinical scenarios. Multimodal imaging protocols that incorporate CMR and computed tomography provide a complex evaluation for both respiratory and cardiovascular complications of SARS-CoV2 infection. This, in relation to biological evaluation of systemic inflammation, can guide appropriate therapeutic management in every stage of the disease. The use of artificial intelligence can further improve the diagnostic accuracy of these imaging techniques, thus enabling risk stratification and evaluation of prognosis. The present manuscript aims to review the current knowledge on the possible modalities for imaging COVID-related myocardial inflammation or post-COVID coronary inflammation and atherosclerosis.
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