Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19
<strong>Background:</strong> Patients with a history of COVID-19 infection are reported to have cardiac abnormalities on cardiovascular magnetic resonance (CMR) during convalescence. However, it is unclear whether these abnormalities were present during the acute COVID-19 illness and how...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Frontiers Media
2023
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| _version_ | 1797110021229641728 |
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| author | Shanmuganathan, M Kotronias, RA Burrage, MK Ng, Y Banerjee, A Xie, C Fletcher, A Manley, P Borlotti, A Emfietzoglou, M Mentzer, AJ Marin, F Raman, B Tunnicliffe, EM Neubauer, S Piechnik, SK Channon, KM Ferreira, VM |
| author2 | Oxford Acute Myocardial Infarction (OxAMI) investigators |
| author_facet | Oxford Acute Myocardial Infarction (OxAMI) investigators Shanmuganathan, M Kotronias, RA Burrage, MK Ng, Y Banerjee, A Xie, C Fletcher, A Manley, P Borlotti, A Emfietzoglou, M Mentzer, AJ Marin, F Raman, B Tunnicliffe, EM Neubauer, S Piechnik, SK Channon, KM Ferreira, VM |
| author_sort | Shanmuganathan, M |
| collection | OXFORD |
| description | <strong>Background:</strong> Patients with a history of COVID-19 infection are reported to have cardiac abnormalities on cardiovascular magnetic resonance (CMR) during convalescence. However, it is unclear whether these abnormalities were present during the acute COVID-19 illness and how they may evolve over time.
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Methods: </strong>We prospectively recruited unvaccinated patients hospitalized with acute COVID-19 (n = 23), and compared them with matched outpatient controls without COVID-19 (n = 19) between May 2020 and May 2021. Only those without a past history of cardiac disease were recruited. We performed in-hospital CMR at a median of 3 days (IQR 1–7 days) after admission, and assessed cardiac function, edema and necrosis/fibrosis, using left and right ventricular ejection fraction (LVEF, RVEF), T1-mapping, T2 signal intensity ratio (T2SI), late gadolinium enhancement (LGE) and extracellular volume (ECV). Acute COVID-19 patients were invited for follow-up CMR and blood tests at 6 months.
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Results: </strong>The two cohorts were well matched in baseline clinical characteristics. Both had normal LVEF (62 ± 7 vs. 65 ± 6%), RVEF (60 ± 6 vs. 58 ± 6%), ECV (31 ± 3 vs. 31 ± 4%), and similar frequency of LGE abnormalities (16 vs. 14%; all p > 0.05). However, measures of acute myocardial edema (T1 and T2SI) were significantly higher in patients with acute COVID-19 when compared to controls (T1 = 1,217 ± 41 ms vs. 1,183 ± 22 ms; p = 0.002; T2SI = 1.48 ± 0.36 vs. 1.13 ± 0.09; p < 0.001). All COVID-19 patients who returned for follow up (n = 12) at 6 months had normal biventricular function, T1 and T2SI.<br><strong>
Conclusion: </strong>Unvaccinated patients hospitalized for acute COVID-19 demonstrated CMR imaging evidence of acute myocardial edema, which normalized at 6 months, while biventricular function and scar burden were similar when compared to controls. Acute COVID-19 appears to induce acute myocardial edema in some patients, which resolves in convalescence, without significant impact on biventricular structure and function in the acute and short-term. Further studies with larger numbers are needed to confirm these findings. |
| first_indexed | 2024-03-07T07:49:24Z |
| format | Journal article |
| id | oxford-uuid:0a80b5db-fbe2-46eb-8cae-7c52a5f9f08e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:49:24Z |
| publishDate | 2023 |
| publisher | Frontiers Media |
| record_format | dspace |
| spelling | oxford-uuid:0a80b5db-fbe2-46eb-8cae-7c52a5f9f08e2023-07-03T18:17:55ZAcute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0a80b5db-fbe2-46eb-8cae-7c52a5f9f08eEnglishSymplectic ElementsFrontiers Media2023Shanmuganathan, MKotronias, RABurrage, MKNg, YBanerjee, AXie, CFletcher, AManley, PBorlotti, AEmfietzoglou, MMentzer, AJMarin, FRaman, BTunnicliffe, EMNeubauer, SPiechnik, SKChannon, KMFerreira, VMOxford Acute Myocardial Infarction (OxAMI) investigators<strong>Background:</strong> Patients with a history of COVID-19 infection are reported to have cardiac abnormalities on cardiovascular magnetic resonance (CMR) during convalescence. However, it is unclear whether these abnormalities were present during the acute COVID-19 illness and how they may evolve over time. <br><strong> Methods: </strong>We prospectively recruited unvaccinated patients hospitalized with acute COVID-19 (n = 23), and compared them with matched outpatient controls without COVID-19 (n = 19) between May 2020 and May 2021. Only those without a past history of cardiac disease were recruited. We performed in-hospital CMR at a median of 3 days (IQR 1–7 days) after admission, and assessed cardiac function, edema and necrosis/fibrosis, using left and right ventricular ejection fraction (LVEF, RVEF), T1-mapping, T2 signal intensity ratio (T2SI), late gadolinium enhancement (LGE) and extracellular volume (ECV). Acute COVID-19 patients were invited for follow-up CMR and blood tests at 6 months. <br><strong> Results: </strong>The two cohorts were well matched in baseline clinical characteristics. Both had normal LVEF (62 ± 7 vs. 65 ± 6%), RVEF (60 ± 6 vs. 58 ± 6%), ECV (31 ± 3 vs. 31 ± 4%), and similar frequency of LGE abnormalities (16 vs. 14%; all p > 0.05). However, measures of acute myocardial edema (T1 and T2SI) were significantly higher in patients with acute COVID-19 when compared to controls (T1 = 1,217 ± 41 ms vs. 1,183 ± 22 ms; p = 0.002; T2SI = 1.48 ± 0.36 vs. 1.13 ± 0.09; p < 0.001). All COVID-19 patients who returned for follow up (n = 12) at 6 months had normal biventricular function, T1 and T2SI.<br><strong> Conclusion: </strong>Unvaccinated patients hospitalized for acute COVID-19 demonstrated CMR imaging evidence of acute myocardial edema, which normalized at 6 months, while biventricular function and scar burden were similar when compared to controls. Acute COVID-19 appears to induce acute myocardial edema in some patients, which resolves in convalescence, without significant impact on biventricular structure and function in the acute and short-term. Further studies with larger numbers are needed to confirm these findings. |
| spellingShingle | Shanmuganathan, M Kotronias, RA Burrage, MK Ng, Y Banerjee, A Xie, C Fletcher, A Manley, P Borlotti, A Emfietzoglou, M Mentzer, AJ Marin, F Raman, B Tunnicliffe, EM Neubauer, S Piechnik, SK Channon, KM Ferreira, VM Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title | Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title_full | Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title_fullStr | Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title_full_unstemmed | Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title_short | Acute changes in myocardial tissue characteristics during hospitalization in patients with COVID-19 |
| title_sort | acute changes in myocardial tissue characteristics during hospitalization in patients with covid 19 |
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