Cardiac MRI in patients with COVID-19 infection

Abstract

Objective COVID-19 infection is a systemic disease with various cardiovascular symptoms and complications. Cardiac MRI with late gadolinium enhancement is the modality of choice for the assessment of myocardial involvement. T1 and T2 mapping can increase diagnostic accuracy and improve further management. Our study aimed to evaluate the different aspects of myocardial damage in cases of COVID-19 infection using cardiac MRI. Methods This descriptive retrospective study included 86 cases, with a history of COVID-19 infection confirmed by positive RT-PCR, who met the inclusion criteria. Patients had progressive chest pain or dyspnoea with a suspected underlying cardiac cause, either by an abnormal electrocardiogram or elevated troponin levels. Cardiac MRI was performed with late contrast-enhanced (LGE) imaging, followed by T1 and T2 mapping. Results Twenty-four patients have elevated hsTnT with a median hsTnT value of 133 ng/L (IQR: 102 to 159 ng/L); normal value < 14 ng/L. Other sixty-two patients showed elevated hsTnI with a median hsTnI value of 1637 ng/L (IQR: 1340 to 2540 ng/L); normal value < 40 ng/L. CMR showed 52 patients with acute myocarditis, 23 with Takotsubo cardiomyopathy, and 11 with myocardial infarction. Invasive coronary angiography was performed only in selected patients. Conclusion Different COVID-19-related cardiac injuries may cause similar clinical symptoms. Cardiac MRI is the modality of choice to differentiate between the different types of myocardial injury such as Takotsubo cardiomyopathy and infection-related cardiomyopathy or even acute coronary syndrome secondary to vasculitis or oxygen-demand mismatch. Key Points • It is essential to detect early COVID-related cardiac injury using different cardiac biomarkers and cardiac imaging, as it has a significant impact on patient management and outcome. • Cardiac MRI is the modality of choice to differentiate between the different aspects of COVID-related myocardial injury.

Gender disparities, causes and predictors of immediate and short-term cardiovascular readmissions following COVID-19-related hospitalisations in the USA

“…[14][15][16] A study conducted by Abdeldayem et al looked at cardiac MRI in 86 patients with cardiac symptoms and COVID-19 positivity, 52 patients had a radiological diagnosis of myocarditis-like acute cardiac syndrome, 23 had Takotsubo cardiomyopathy and 11 had acute coronary syndrome due to coronary vasculitis or oxygen demand mismatch. 17 Another study by Tudoran et al evaluated 383 patients recovering from COVID-19 who had persistent symptoms and discovered abnormalities in transthoracic echocardiogram in 102 (26.6%) patients; the most frequent pattern was diastolic dysfunction with normal left ventricular ejection fraction (LVEF). 18 Ruge et al presented 60-day readmission data following COVID-19 infection, involving 1406 patients who survived the index hospitalisation.…”

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