Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis
Myocarditis is a rare complication of the COVID-19 mRNA vaccine. We previously reported a case series of 15 adolescents with vaccine-associated myocarditis, 87% of whom had abnormalities on initial cardiac magnetic resonance (CMR), including late gadolinium enhancement (LGE) in 80%. We performed fol...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046711/ https://www.ncbi.nlm.nih.gov/pubmed/35482094 http://dx.doi.org/10.1007/s00431-022-04482-z |
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author | Hadley, Stephanie M. Prakash, Ashwin Baker, Annette L. de Ferranti, Sarah D. Newburger, Jane W. Friedman, Kevin G. Dionne, Audrey |
author_facet | Hadley, Stephanie M. Prakash, Ashwin Baker, Annette L. de Ferranti, Sarah D. Newburger, Jane W. Friedman, Kevin G. Dionne, Audrey |
author_sort | Hadley, Stephanie M. |
collection | PubMed |
description | Myocarditis is a rare complication of the COVID-19 mRNA vaccine. We previously reported a case series of 15 adolescents with vaccine-associated myocarditis, 87% of whom had abnormalities on initial cardiac magnetic resonance (CMR), including late gadolinium enhancement (LGE) in 80%. We performed follow-up CMRs to determine the trajectory of myocardial recovery and better understand the natural history of vaccine-associated myocarditis. Case series of patients age < 19 years admitted to Boston Children’s Hospital with acute vaccine-associated myocarditis following the BNT162b2 vaccine who had abnormal CMR at the time of initial presentation, and underwent follow-up testing. CMR assessment included left ventricular (LV) ejection fraction, T2-weighted myocardial imaging, LV global native T1, LV global T2, extracellular volume (ECV), and late gadolinium enhancement (LGE). Ten patients (9 male, median age 15 years) with vaccine-associated myocarditis underwent follow-up CMR at a median of 92 days (range 76–119) after hospital discharge. LGE was persistent in 80% of patients, though improved from prior in all cases. Two patients (20%) had abnormal LV global T1 at presentation, which normalized on follow-up. ECV decreased between acute presentation and follow-up in 6/10 patients; it remained elevated at follow-up in 1 patient and borderline in 3 patients. Conclusion: CMR performed ~3 months after admission for COVID-19 vaccine-associated myocarditis showed improvement of LGE in all patients, but persistent in the majority. Follow-up CMR 6–12 months after acute episode should be considered to better understand the long-term cardiac risks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-022-04482-z. |
format | Online Article Text |
id | pubmed-9046711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-90467112022-04-28 Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis Hadley, Stephanie M. Prakash, Ashwin Baker, Annette L. de Ferranti, Sarah D. Newburger, Jane W. Friedman, Kevin G. Dionne, Audrey Eur J Pediatr Short Communication Myocarditis is a rare complication of the COVID-19 mRNA vaccine. We previously reported a case series of 15 adolescents with vaccine-associated myocarditis, 87% of whom had abnormalities on initial cardiac magnetic resonance (CMR), including late gadolinium enhancement (LGE) in 80%. We performed follow-up CMRs to determine the trajectory of myocardial recovery and better understand the natural history of vaccine-associated myocarditis. Case series of patients age < 19 years admitted to Boston Children’s Hospital with acute vaccine-associated myocarditis following the BNT162b2 vaccine who had abnormal CMR at the time of initial presentation, and underwent follow-up testing. CMR assessment included left ventricular (LV) ejection fraction, T2-weighted myocardial imaging, LV global native T1, LV global T2, extracellular volume (ECV), and late gadolinium enhancement (LGE). Ten patients (9 male, median age 15 years) with vaccine-associated myocarditis underwent follow-up CMR at a median of 92 days (range 76–119) after hospital discharge. LGE was persistent in 80% of patients, though improved from prior in all cases. Two patients (20%) had abnormal LV global T1 at presentation, which normalized on follow-up. ECV decreased between acute presentation and follow-up in 6/10 patients; it remained elevated at follow-up in 1 patient and borderline in 3 patients. Conclusion: CMR performed ~3 months after admission for COVID-19 vaccine-associated myocarditis showed improvement of LGE in all patients, but persistent in the majority. Follow-up CMR 6–12 months after acute episode should be considered to better understand the long-term cardiac risks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-022-04482-z. Springer Berlin Heidelberg 2022-04-28 2022 /pmc/articles/PMC9046711/ /pubmed/35482094 http://dx.doi.org/10.1007/s00431-022-04482-z Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Short Communication Hadley, Stephanie M. Prakash, Ashwin Baker, Annette L. de Ferranti, Sarah D. Newburger, Jane W. Friedman, Kevin G. Dionne, Audrey Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title | Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title_full | Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title_fullStr | Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title_full_unstemmed | Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title_short | Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
title_sort | follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046711/ https://www.ncbi.nlm.nih.gov/pubmed/35482094 http://dx.doi.org/10.1007/s00431-022-04482-z |
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