tetano
Editor, Senior Moderator
Radiology
. 2021 Aug 10;211162.
doi: 10.1148/radiol.2021211162. Online ahead of print.
Cardiac MRI in Patients with Prolonged Cardiorespiratory Symptoms after Mild to Moderate COVID-19 Infection
Dmitrij Kravchenko[SUP] 1 2 [/SUP], Alexander Isaak[SUP] 1 2 [/SUP], Sebastian Zimmer[SUP] 3 [/SUP], Narine Mesropyan[SUP] 1 2 [/SUP], Matthäus Reinert[SUP] 1 2 [/SUP], Anton Faron[SUP] 1 2 [/SUP], Claus C Pieper[SUP] 1 [/SUP], Annkristin Heine[SUP] 4 [/SUP], Markus Velten[SUP] 5 [/SUP], Jacob Nattermann[SUP] 6 [/SUP], Daniel Kuetting[SUP] 1 2 [/SUP], Georg D Duerr[SUP] 7 [/SUP], Ulrike I Attenberger[SUP] 1 [/SUP], Julian A Luetkens[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background Myocardial injury and inflammation on cardiac MRI in patients suffering from coronavirus disease 19 (COVID-19) have been described in recent publications. Concurrently, a chronic COVID-19 syndrome (CCS) after COVID-19 infection has been observed manifesting with symptoms like fatigue and exertional dyspnea. Purpose To explore the relationship between CCS and myocardial injury and inflammation as an underlying cause of the persistent complaints in previously healthy individuals. Materials and Methods In this prospective study from January 2021 to April 2021, study participants without known cardiac or pulmonary diseases prior to COVID-19 infection with persisting CCS symptoms like fatigue or exertional dyspnea after convalescence and healthy control participants underwent cardiac MRI. Cardiac MRI protocol included T1 and T2 relaxation times, extracellular volume (ECV), T2 signal intensity ratio, and late gadolinium enhancement (LGE). Student t test, Mann-Whitney U test, and χ[SUP]2[/SUP] test were used for statistical analysis. Results 41 participants with CCS (39±13 years; 18 men) and 42 control participants (39±16 years; 26 men) were evaluated. Median time between initial mild to moderate COVID-19 disease without hospitalization and cardiac MRI was 103 days (interquartile range: 88-158). Troponin T levels were normal. Parameters indicating myocardial inflammation and edema were comparable between participants with CCS and control participants: T1 relaxation time (978±23 ms vs 971±25 ms; P=.17), T2 relaxation time (53±2 ms vs 52±2 ms; P=.47), T2 signal intensity ratio (1.6±0.2 vs 1.6±0.3; P=.10). Visible myocardial edema was present in none of the participants. Three of 41 (7%) participants with CCS demonstrated non-ischemic LGE compared to none in the control group (0 of 42 [0%]; P=.07). None of the participants fulfilled the 2018 Lake Louise criteria for the diagnosis of myocarditis. Conclusion Individuals without hospitalization for COVID-19 and with CCS did not demonstrate signs of active myocardial injury or inflammation on cardiac MRI. See also the editorial by Lima and Bluemke.
. 2021 Aug 10;211162.
doi: 10.1148/radiol.2021211162. Online ahead of print.
Cardiac MRI in Patients with Prolonged Cardiorespiratory Symptoms after Mild to Moderate COVID-19 Infection
Dmitrij Kravchenko[SUP] 1 2 [/SUP], Alexander Isaak[SUP] 1 2 [/SUP], Sebastian Zimmer[SUP] 3 [/SUP], Narine Mesropyan[SUP] 1 2 [/SUP], Matthäus Reinert[SUP] 1 2 [/SUP], Anton Faron[SUP] 1 2 [/SUP], Claus C Pieper[SUP] 1 [/SUP], Annkristin Heine[SUP] 4 [/SUP], Markus Velten[SUP] 5 [/SUP], Jacob Nattermann[SUP] 6 [/SUP], Daniel Kuetting[SUP] 1 2 [/SUP], Georg D Duerr[SUP] 7 [/SUP], Ulrike I Attenberger[SUP] 1 [/SUP], Julian A Luetkens[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34374593
- DOI: 10.1148/radiol.2021211162
Abstract
Background Myocardial injury and inflammation on cardiac MRI in patients suffering from coronavirus disease 19 (COVID-19) have been described in recent publications. Concurrently, a chronic COVID-19 syndrome (CCS) after COVID-19 infection has been observed manifesting with symptoms like fatigue and exertional dyspnea. Purpose To explore the relationship between CCS and myocardial injury and inflammation as an underlying cause of the persistent complaints in previously healthy individuals. Materials and Methods In this prospective study from January 2021 to April 2021, study participants without known cardiac or pulmonary diseases prior to COVID-19 infection with persisting CCS symptoms like fatigue or exertional dyspnea after convalescence and healthy control participants underwent cardiac MRI. Cardiac MRI protocol included T1 and T2 relaxation times, extracellular volume (ECV), T2 signal intensity ratio, and late gadolinium enhancement (LGE). Student t test, Mann-Whitney U test, and χ[SUP]2[/SUP] test were used for statistical analysis. Results 41 participants with CCS (39±13 years; 18 men) and 42 control participants (39±16 years; 26 men) were evaluated. Median time between initial mild to moderate COVID-19 disease without hospitalization and cardiac MRI was 103 days (interquartile range: 88-158). Troponin T levels were normal. Parameters indicating myocardial inflammation and edema were comparable between participants with CCS and control participants: T1 relaxation time (978±23 ms vs 971±25 ms; P=.17), T2 relaxation time (53±2 ms vs 52±2 ms; P=.47), T2 signal intensity ratio (1.6±0.2 vs 1.6±0.3; P=.10). Visible myocardial edema was present in none of the participants. Three of 41 (7%) participants with CCS demonstrated non-ischemic LGE compared to none in the control group (0 of 42 [0%]; P=.07). None of the participants fulfilled the 2018 Lake Louise criteria for the diagnosis of myocarditis. Conclusion Individuals without hospitalization for COVID-19 and with CCS did not demonstrate signs of active myocardial injury or inflammation on cardiac MRI. See also the editorial by Lima and Bluemke.