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...

Descripción completa

Detalles Bibliográficos
Autores principales: Hadley, Stephanie M., Prakash, Ashwin, Baker, Annette L., de Ferranti, Sarah D., Newburger, Jane W., Friedman, Kevin G., Dionne, Audrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
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
_version_ 1784695569442144256
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
work_keys_str_mv AT hadleystephaniem followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT prakashashwin followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT bakerannettel followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT deferrantisarahd followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT newburgerjanew followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT friedmankeving followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis
AT dionneaudrey followupcardiacmagneticresonanceinchildrenwithvaccineassociatedmyocarditis