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Myocardial Injury on CMR in Patients With COVID-19 ...
Article: Myocardial Injury on CMR in Patients With ...
Article: Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement - JIMG May 2023
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This study aimed to understand myocardial injury in COVID-19 patients suspecting cardiac involvement by using cardiac magnetic resonance (CMR) imaging across 18 global sites. Analyzing 1,047 patients, the study categorized myocardial injuries into nonischemic (including acute myocarditis and nonacute nonischemic patterns) and ischemic (both acute and nonacute patterns).<br /><br />Key findings revealed:<br />- 20.9% exhibited nonischemic injuries with 7.9% acute myocarditis and 13% nonacute nonischemic.<br />- 6.7% showed ischemic injuries, where 1.9% were acute, and 4.8% nonacute.<br />- Hospitalized patients had higher ischemic injury rates (acute ischemic injuries: 3.4%) than ambulatory patients (0.9%). Nonischemic patterns were more evenly distributed in both groups.<br />- Troponin elevation strongly correlated with acute myocardial damage. Elevated troponin was observed in 26.9% of the patients, and 25.1% of these had ischemic injury patterns.<br /><br />Overall, CMR helped in differentiating myocardial injury types, showcasing significant occurrences of both nonischemic and ischemic injuries in COVID-19 patients. Clinical factors such as chest discomfort, ECG abnormalities, elevated troponin, and natriuretic peptide levels were associated with myocardial injury patterns. These findings could guide clinicians in identifying patients who might benefit from CMR for further cardiac evaluation, enhancing diagnosis and management in COVID-19 related cardiac events. Further studies are needed to establish the long-term prognosis of these CMR detected injuries in COVID-19 patients.
Keywords
myocardial injury
COVID-19
cardiac magnetic resonance
acute myocarditis
ischemic injuries
troponin elevation
hospitalized patients
nonischemic patterns
ECG abnormalities
chest discomfort
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