Myocardial deformation assessed by CMR in children after multisystem inflammatory syndrome (MIS-C)

Area of Science:

• Cardiology
• Pediatric Cardiology
• Cardiovascular Imaging

Background:

• Multisystem Inflammatory Syndrome in Children (MIS-C) can lead to cardiac abnormalities.
• Previous studies indicated rapid improvement but potential subtle residual myocardial interstitial abnormalities.
• Assessing myocardial deformation shortly after MIS-C is crucial for understanding long-term effects.

Purpose of the Study:

• To evaluate myocardial deformation using Cardiac Magnetic Resonance (CMR) in children recently diagnosed with MIS-C.
• To compare myocardial strain values in MIS-C patients with healthy controls and established pediatric norms.
• To identify potential subclinical myocardial dysfunction following MIS-C.

Main Methods:

• A cohort of 60 children was studied, including 30 patients with recent MIS-C and 30 age-matched controls.
• Myocardial strain parameters were assessed using CMR, with a mean onset-to-scan time of 27 days for MIS-C patients.
• Statistical comparison of strain values between groups was performed using the U-Mann Whitney test, with comparisons to published pediatric CMR data.

Main Results:

• All conventional CMR parameters were within normal limits for MIS-C patients.
• Significantly lower global radial and circumferential strain values were observed in MIS-C patients compared to controls.
• While most patients had global longitudinal strain within normal centiles, some showed values between the 2.5th and 50th centile, with one below the 2.5th centile.

Conclusions:

• Myocardial deformation indices assessed by CMR are largely within normal ranges shortly after MIS-C onset.
• Despite normal conventional CMR parameters, all strain parameters were reduced in MIS-C patients compared to healthy controls.
• Subtle impairments in myocardial deformation may persist in some children after MIS-C, warranting further investigation.