Background: Accumulating evidence has revealed that coronavirus disease 2019 (COVID-19) patients may be complicated with myocardial injury during hospitalization. However, data regarding persistent cardiac involvement in patients who recovered from COVID-19 are limited. Our goal is to further explore the sustained impact of COVID-19 during follow-up, focusing on the cardiac involvement in the recovered patients.Methods: In this prospective observational follow-up study, we enrolled a total of 40 COVID-19 patients (20 with and 20 without cardiac injury during hospitalization) who were discharged from Zhongnan Hospital of Wuhan University for more than 6 months, and 27 patients (13 with and 14 without cardiac injury during hospitalization) were finally included in the analysis. Clinical information including self-reported symptoms, medications, laboratory findings, Short Form 36-item scores, 6-min walk test, clinical events, electrocardiogram assessment, echocardiography measurement, and cardiac magnetic resonance imaging was collected and analyzed.Results: Among 27 patients finally included, none of patients reported any obvious cardiopulmonary symptoms at the 6-month follow-up. There were no statistically significant differences in terms of the quality of life and exercise capacity between the patients with and without cardiac injury. No significant abnormalities were detected in electrocardiogram manifestations in both groups, except for nonspecific ST-T changes, premature beats, sinus tachycardia/bradycardia, PR interval prolongation, and bundle-branch block. All patients showed normal cardiac structure and function, without any statistical differences between patients with and without cardiac injury by echocardiography. Compared with patients without cardiac injury, patients with cardiac injury exhibited a significantly higher positive proportion in late gadolinium enhancement sequences [7/13 (53.8%) vs. 1/14 (7.1%), p = 0.013], accompanied by the elevation of circulating ST2 level [median (interquartile range) = 16.6 (12.1, 22.5) vs. 12.5 (9.5, 16.7); p = 0.044]. Patients with cardiac injury presented higher levels of aspartate aminotransferase, creatinine, high-sensitivity troponin I, lactate dehydrogenase, and N-terminal pro–B-type natriuretic peptide than those without cardiac injury, although these indexes were within the normal range for all recovered patients at the 6-month follow-up. Among patients with cardiac injury, patients with positive late gadolinium enhancement presented higher cardiac biomarker (high-sensitivity troponin I) and inflammatory factor (high-sensitivity C-reactive protein) on admission than the late gadolinium enhancement–negative subgroup.Conclusions: Our preliminary 6-month follow-up study with a limited number of patients revealed persistent cardiac involvement in 29.6% (8/27) of recovered patients from COVID-19 after discharge. Patients with cardiac injury during hospitalization were more prone to develop cardiac fibrosis during their recovery. Among patients with cardiac injury, those with relatively higher cardiac biomarkers and inflammatory factors on admission appeared more likely to have cardiac involvement in the convalescence phase.

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Background Clinical-radiological correlation of myocardial bridge (MB) remains unclear. Purpose To correlate clinical symptoms and outcomes of MBs with computed tomography (CT) coronary angiography findings. Material and Methods A total of 2092 patients with CT coronary angiography were collected. Patients were divided into symptomatic and asymptomatic groups, adverse heart events (AHE) and non-AHE groups, MB and non-MB groups, as well as left anterior descending (LAD)-MB and non-LAD-MB groups. Statistical analyses were performed to identify inter-group differences, and clinical-radiological correlations of MBs or mural coronary arteries (MCAs). Results The prevalence of MB, the MCA stenosis either in systole or in diastole, and the ratio of LAD-MB were significantly higher in the symptomatic group than in the asymptomatic group, and higher in the AHE group than in the non-AHE group ( P all <0.05). MB thickness, systolic MCA stenosis, and diastolic MCA stenosis were independent variables predicting clinical symptoms ( P < 0.05), with diastolic MCA stenosis having the highest diagnostic performance, when cutting at 24.6%. The corresponding sensitivity and specificity were 87.8% and 90.6%, respectively. Diastolic MCA stenosis independently indicated outcome of AHE (odds ratio, 1.047; P < 0.001). Conclusion Measurements of MB-MCA by CT predict the presence of clinical symptoms and outcomes of AHE, with diastolic MCA stenosis possessing the greatest performance.

Braid-like coronary artery is very rare. It is featured by the division of the coronary artery into multiple tortuous small channels that later converge into a normal lumen at any segment of the coronary artery. We presented a case of a 27-year-old male patient with occasional chest pain. In coronary CT angiography (CCTA) and coronary angiography, a braid-like appearance was found in the right coronary artery. After multidisciplinary discussion, it was speculated to be a woven coronary artery (WCA). We conducted a literature review about woven coronary arteries.