Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement

BACKGROUND: Myocardial injury in patients with COVID-19 and suspected cardiac involvement is not well understood. OBJECTIVES: The purpose of this study was to characterize myocardial injury in a multicenter cohort of patients with COVID-19 and suspected cardiac involvement referred for cardiac magne...

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Detalles Bibliográficos
Autores principales: Vidula, Mahesh K., Rajewska-Tabor, Justyna, Cao, J. Jane, Kang, Yu, Craft, Jason, Mei, Winifred, Chandrasekaran, Preethi S., Clark, Daniel E., Poenar, Ana-Maria, Gorecka, Miroslawa, Malahfji, Maan, Cowan, Eilidh, Kwan, Jennifer M., Reinhardt, Samuel W., Al-Tabatabaee, Sarah, Doeblin, Patrick, Villa, Adriana D.M., Karagodin, Ilya, Alvi, Nazia, Christia, Panagiota, Spetko, Nicholas, Cassar, Mark Philip, Park, Christine, Nambiar, Lakshmi, Turgut, Alper, Azad, Mahan Roosta, Lambers, Moritz, Wong, Timothy C., Salerno, Michael, Kim, Jiwon, Elliott, Michael, Raman, Betty, Neubauer, Stefan, Tsao, Connie W., LaRocca, Gina, Patel, Amit R., Chiribiri, Amedeo, Kelle, Sebastian, Baldassarre, Lauren A., Shah, Dipan J., Hughes, Sean G., Tong, Matthew S., Pyda, Malgorzata, Simonetti, Orlando P., Plein, Sven, Han, Yuchi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the American College of Cardiology Foundation. Published by Elsevier. 2023
Materias:
Original Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9833283/
https://www.ncbi.nlm.nih.gov/pubmed/36752429
http://dx.doi.org/10.1016/j.jcmg.2022.10.021
Descripción
Sumario:BACKGROUND: Myocardial injury in patients with COVID-19 and suspected cardiac involvement is not well understood. OBJECTIVES: The purpose of this study was to characterize myocardial injury in a multicenter cohort of patients with COVID-19 and suspected cardiac involvement referred for cardiac magnetic resonance (CMR). METHODS: This retrospective study consisted of 1,047 patients from 18 international sites with polymerase chain reaction–confirmed COVID-19 infection who underwent CMR. Myocardial injury was characterized as acute myocarditis, nonacute/nonischemic, acute ischemic, and nonacute/ischemic patterns on CMR. RESULTS: In this cohort, 20.9% of patients had nonischemic injury patterns (acute myocarditis: 7.9%; nonacute/nonischemic: 13.0%), and 6.7% of patients had ischemic injury patterns (acute ischemic: 1.9%; nonacute/ischemic: 4.8%). In a univariate analysis, variables associated with acute myocarditis patterns included chest discomfort (OR: 2.00; 95% CI: 1.17-3.40, P = 0.01), abnormal electrocardiogram (ECG) (OR: 1.90; 95% CI: 1.12-3.23; P = 0.02), natriuretic peptide elevation (OR: 2.99; 95% CI: 1.60-5.58; P = 0.0006), and troponin elevation (OR: 4.21; 95% CI: 2.41-7.36; P < 0.0001). Variables associated with acute ischemic patterns included chest discomfort (OR: 3.14; 95% CI: 1.04-9.49; P = 0.04), abnormal ECG (OR: 4.06; 95% CI: 1.10-14.92; P = 0.04), known coronary disease (OR: 33.30; 95% CI: 4.04-274.53; P = 0.001), hospitalization (OR: 4.98; 95% CI: 1.55-16.05; P = 0.007), natriuretic peptide elevation (OR: 4.19; 95% CI: 1.30-13.51; P = 0.02), and troponin elevation (OR: 25.27; 95% CI: 5.55-115.03; P < 0.0001). In a multivariate analysis, troponin elevation was strongly associated with acute myocarditis patterns (OR: 4.98; 95% CI: 1.76-14.05; P = 0.003). CONCLUSIONS: In this multicenter study of patients with COVID-19 with clinical suspicion for cardiac involvement referred for CMR, nonischemic and ischemic patterns were frequent when cardiac symptoms, ECG abnormalities, and cardiac biomarker elevations were present.

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