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Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data
BACKGROUND: Cardiac involvement is central in MIS-C and represents the main cause of morbidity. In this study, we aimed to assess myocardial damage in patients with MIS-C using cardiac magnetic resonance (CMR) during the acute phase, as well as left ventricular and atrial longitudinal strain on admi...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657844/ https://www.ncbi.nlm.nih.gov/pubmed/38028482 http://dx.doi.org/10.3389/fcvm.2023.1288176 |
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author | Scarduelli, Lorenzo De Guillebon De Resnes, Jean-Marie Ducreux, Dorothée Bernardor, Julie Afanetti, Mickael Dupont, Audrey Barthelemy, Sébastien Gondon, Emmanuelle Leporati, Julien Giovannini-Chami, Lisa Moceri, Pamela |
author_facet | Scarduelli, Lorenzo De Guillebon De Resnes, Jean-Marie Ducreux, Dorothée Bernardor, Julie Afanetti, Mickael Dupont, Audrey Barthelemy, Sébastien Gondon, Emmanuelle Leporati, Julien Giovannini-Chami, Lisa Moceri, Pamela |
author_sort | Scarduelli, Lorenzo |
collection | PubMed |
description | BACKGROUND: Cardiac involvement is central in MIS-C and represents the main cause of morbidity. In this study, we aimed to assess myocardial damage in patients with MIS-C using cardiac magnetic resonance (CMR) during the acute phase, as well as left ventricular and atrial longitudinal strain on admission, at discharge, and after 3 months. METHODS: We performed a single-center prospective cohort study and case–control study. Between September 2020 and February 2022, we enrolled 39 patients hospitalized for MIS-C at our center. We performed left ventricular and atrial longitudinal 2D strain analysis on admission and during follow-up; echocardiographic data were compared to a matched control population. Patients above 4 years old with increased troponin underwent CMR. RESULTS: Of 24 patients (mean age: 8.2 ± 4.9 years) who underwent CMR, 14 (58%) presented myocardial edema and 6 (25%) late gadolinium enhancement (LGE). LGE was associated with older age (p < 0.01), increased BMI (p = 0.03), increased ferritin levels (p < 0.001), lower left ventricular (LV) ejection fraction (p < 0.001), LV longitudinal strain (p = 0.004), left atrial (LA) strain (p = 0.05), and prolonged hospital stay (p = 0.02). On admission, LV ejection fraction, LV longitudinal strain, and LA strain were impaired, but each improved gradually over time; LVEF was the fastest to recover, while global LV longitudinal strain was still impaired as compared to controls after 3 months (p = 0.01). CONCLUSION: Our study demonstrates that myocardial injury is present in a quarter of MIS-C patients, and impaired LA and LV myocardial deformation persist for at least several weeks after the acute phase. CMR and LV/LA strain could help us to individualize follow-up of MIS-C patients. |
format | Online Article Text |
id | pubmed-10657844 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106578442023-01-01 Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data Scarduelli, Lorenzo De Guillebon De Resnes, Jean-Marie Ducreux, Dorothée Bernardor, Julie Afanetti, Mickael Dupont, Audrey Barthelemy, Sébastien Gondon, Emmanuelle Leporati, Julien Giovannini-Chami, Lisa Moceri, Pamela Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Cardiac involvement is central in MIS-C and represents the main cause of morbidity. In this study, we aimed to assess myocardial damage in patients with MIS-C using cardiac magnetic resonance (CMR) during the acute phase, as well as left ventricular and atrial longitudinal strain on admission, at discharge, and after 3 months. METHODS: We performed a single-center prospective cohort study and case–control study. Between September 2020 and February 2022, we enrolled 39 patients hospitalized for MIS-C at our center. We performed left ventricular and atrial longitudinal 2D strain analysis on admission and during follow-up; echocardiographic data were compared to a matched control population. Patients above 4 years old with increased troponin underwent CMR. RESULTS: Of 24 patients (mean age: 8.2 ± 4.9 years) who underwent CMR, 14 (58%) presented myocardial edema and 6 (25%) late gadolinium enhancement (LGE). LGE was associated with older age (p < 0.01), increased BMI (p = 0.03), increased ferritin levels (p < 0.001), lower left ventricular (LV) ejection fraction (p < 0.001), LV longitudinal strain (p = 0.004), left atrial (LA) strain (p = 0.05), and prolonged hospital stay (p = 0.02). On admission, LV ejection fraction, LV longitudinal strain, and LA strain were impaired, but each improved gradually over time; LVEF was the fastest to recover, while global LV longitudinal strain was still impaired as compared to controls after 3 months (p = 0.01). CONCLUSION: Our study demonstrates that myocardial injury is present in a quarter of MIS-C patients, and impaired LA and LV myocardial deformation persist for at least several weeks after the acute phase. CMR and LV/LA strain could help us to individualize follow-up of MIS-C patients. Frontiers Media S.A. 2023-11-06 /pmc/articles/PMC10657844/ /pubmed/38028482 http://dx.doi.org/10.3389/fcvm.2023.1288176 Text en © 2023 Scarduelli, De Guillebon De Resnes, Ducreux, Bernardor, Afanetti, Dupont, Barthelemy, Gondon, Leporati, Giovannini-Chami and Moceri. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Scarduelli, Lorenzo De Guillebon De Resnes, Jean-Marie Ducreux, Dorothée Bernardor, Julie Afanetti, Mickael Dupont, Audrey Barthelemy, Sébastien Gondon, Emmanuelle Leporati, Julien Giovannini-Chami, Lisa Moceri, Pamela Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title | Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title_full | Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title_fullStr | Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title_full_unstemmed | Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title_short | Cardiac manifestations of MIS-C: cardiac magnetic resonance and speckle-tracking data |
title_sort | cardiac manifestations of mis-c: cardiac magnetic resonance and speckle-tracking data |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657844/ https://www.ncbi.nlm.nih.gov/pubmed/38028482 http://dx.doi.org/10.3389/fcvm.2023.1288176 |
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