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Myocardial Injury by COVID-19 Infection Assessed by Cardiovascular Magnetic Resonance Imaging - A Prospective
Shingo Kato1, Takeshi Kitai2, Daisuke Utsunomiya1
1Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine.
Insights
Cardiac magnetic resonance imaging (CMR) revealed significant myocardial injury in 42% of moderate to severe COVID-19 patients with abnormal cardiac biomarkers, indicating a high incidence of cardiac complications post-infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Assessed myocardial injury prevalence in COVID-19 patients.
- Utilized cardiac magnetic resonance imaging (CMR) for assessment.
- Prospective multicenter study design.
Purpose of the Study:
- Determine the incidence of myocardial injury in COVID-19 survivors.
- Evaluate cardiac function and myocardial tissue characteristics post-COVID-19.
- Identify predictors or manifestations of cardiac involvement.
Main Methods:
- Screened 505 patients with moderate to severe COVID-19.
- 31 patients with elevated cardiac biomarkers underwent CMR 3 months post-discharge.
- Defined myocardial injury by late gadolinium enhancement, ventricular dysfunction, or pericardial thickening.
Main Results:
- 42% (13/31) of patients showed myocardial injury on CMR.
- 26% (8/31) met criteria for acute myocarditis.
- Mean duration between COVID-19 diagnosis and CMR was 117 days.
Conclusions:
- High incidence of myocardial injury observed in COVID-19 patients with abnormal cardiac biomarkers.
- CMR is effective in detecting cardiac sequelae of COVID-19.
- Findings highlight the importance of cardiac monitoring after COVID-19 infection.
Background:
This prospective multicenter study assessed the prevalence of myocardial injury in patients with COVID-19 using cardiac magnetic resonance imaging (CMR).
Methods And Results:
We prospectively screened 505 patients with moderate to severe COVID-19 disease from 7 hospitals in Japan. Of these patients, 31 (mean [±SD] age 63.5±10.4 years, 23 [74%] male) suspected of myocardial injury, based on elevated serum troponin or B-type natriuretic peptide concentrations either upon admission or 3 months after discharge, underwent CMR 3 months after discharge. The primary endpoint was the presence of myocardial injury, defined by any of the following: (1) contrast enhancement in the left or right ventricle myocardium on late gadolinium enhancement CMR; (2) left or right ventricular dysfunction (defined as <50% and <45%, respectively); and (3) pericardial thickening on contrast enhancement. The mean (±SD) duration between diagnosis and CMR was 117±16 days. The primary endpoint was observed in 13 of 31 individuals (42%), with 8 (26%) satisfying the modified Lake Louise Criteria for the diagnosis of acute myocarditis.
Conclusions:
This study revealed a high incidence of myocardial injury identified by CMR in patients with moderate to severe COVID-19 and abnormal findings for cardiac biomarkers.
