Related Experiment Video
Updated: Jun 6, 2025
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Cardiovascular Magnetic Resonance Reveals Cardiac Inflammation and Fibrosis in Symptomatic Patients with
George Markousis-Mavrogenis1,2, Vasiliki Vartela3, Alessia Pepe4
1University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair in Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
Insights
Cardiovascular magnetic resonance (CMR) effectively assesses cardiac symptoms in post-coronavirus disease-2019 (COVID-19) patients. Multi-parametric CMR reveals non-ischemic myocardial inflammation and abnormalities, aiding in patient evaluation.
Area of Science:
- Cardiology
- Radiology
- Infectious Diseases
Background:
- Post-coronavirus disease-2019 (COVID-19) can manifest with persistent cardiac symptoms.
- Cardiovascular magnetic resonance (CMR) is a key imaging modality for evaluating cardiac conditions.
- Multi-parametric CMR offers detailed insights into myocardial tissue characteristics.
Purpose of the Study:
- To investigate the utility of multi-parametric CMR in assessing cardiac symptoms in post-COVID-19 patients.
- To identify specific CMR findings indicative of myocardial inflammation and injury.
- To evaluate the role of CMR in the short- and long-term management of post-COVID-19 cardiac complications.
Main Methods:
- Retrospective, multicenter study (INSPIRE-CMR) of 174 symptomatic post-COVID-19 patients.
- CMR performed using 3.0 T/1.5 T scanners, with myocardial inflammation assessed by updated Lake Louise criteria.
- Analysis included late gadolinium enhancement (LGE) patterns and T1/T2 mapping indices.
Main Results:
- 86% of patients showed non-ischemic LGE; 97% had abnormal T1 indices, and 36% had abnormal T2 indices.
- 33% of patients exhibited both abnormal T1 and T2 indices.
- Abnormalities were more prevalent in patients with severe COVID-19, indicating a link between disease severity and cardiac involvement.
Conclusions:
- The majority of symptomatic post-COVID-19 patients exhibit non-ischemic LGE and abnormal T1/T2 indices on CMR.
- Multi-parametric CMR provides crucial information for evaluating cardiac status in post-COVID-19 patients.
- CMR is valuable for both short-term and long-term assessment of cardiac sequelae following COVID-19 infection.
Abstract:
Introduction. Post-coronavirus disease-2019 (COVID-19) patients may develop cardiac symptoms. We hypothesized that cardiovascular magnetic resonance (CMR) can assess the background of post-COVID-19 cardiac symptoms using multi-parametric evaluation. We aimed to conduct an investigation of symptomatic patients with post-COVID-19 syndrome using CMR (INSPIRE-CMR). Methods. INSIPRE-CMR is a retrospective multicenter study including 174 patients from five centers referred for CMR due to cardiac symptoms. CMR was performed using 3.0 T/1.5 T system (24%/76%, respectively). Myocardial inflammation was determined by the updated Lake Louise criteria. Results. Further, 174 patients with median age of 40 years (IQR: 26-54), 72 (41%) were women, and 17 (9.7%) had a history of autoimmune disease, muscular dystrophy, or cancer. In total, 149 (86%) patients were late gadolinium enhanced (LGE)-positive with a non-ischemic pattern, and of those evaluated with the updated Lake Louise criteria, 141/145 (97%) had ≥1 pathologic T1 index. Based on the T2-criterion, 62/173 (36%) patients had ≥1 pathologic T2 index. Collectively, 48/145 (33%) patients had both positive T1- and T2-criterion. A positive T2-criterion or a combination of a positive T1- and T2-criterion were significantly more common amongst patients with severe COVID-19 [45 (31%) vs. 17 (65%), p = 0.001 and 32 (27%) vs. 16 (64%), p < 0.001, respectively]. During the one-year evaluation, available for 65/174 patients, shortness of breath, chest pain, and arrhythmia were identified in 7 (4%), 15 (8.6%), and 43 (24.7%), respectively. CMR evaluation, available in a minority of them, showed mildly reduced LVEF, while nat T1 mapping and EVC remained at levels higher than the normal values of the local MRI units. Conclusions. The majority of post-COVID-19 patients with cardiac symptoms presented non-ischemic LGE and abnormalities in T1 and T2-based indices. Multi-parametric CMR reveals important information on post-COVID-19 patients, supporting its role in short/long-term evaluation.
More Related Videos
12:24Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
Published on: June 20, 2014
08:41Assessment of Cardiac Function and Myocardial Morphology Using Small Animal Look-locker Inversion Recovery SALLI MRI in Rats
Published on: July 19, 2013
Related Concept Videos
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:21Myocarditis I: Introduction
01:14Myocarditis III: Medical Management
01:28Imaging Studies for Cardiovascular System V: CT
01:27Myocarditis II: Clinical features and Diagnostic Tests
01:19Pericarditis II: Clinical features and Diagnostic Tests