Contemporary use of cardiac imaging for COVID-19 patients: a three center experience defining a potential role for cardiac MRI

Panchal, Ankur; Kyvernitakis, Andreas; Mikolich, J. Ronald; Biederman, Robert W

doi:10.1007/s10554-020-02139-2

Cited by 10 publications

(8 citation statements)

References 54 publications

(59 reference statements)

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“…[84][85][86] Cardiovascular imaging may offer several advantages in non-invasively evaluating COVID and non-COVID patients with cardiac symptoms during the COVID-19 pandemic (Figure 2). 48,87,88 Newer echocardiography techniques, such as LV global longitudinal strain, may uncover subclinical myocardial dysfunction in a large proportion (*80%) of patients hospitalized with COVID-19, while gross LV dysfunction with decreased LV ejection fraction and wall motion abnormalities are less frequent findings (22%-23%). 87 Myocardial strain imaging may detect myocardial dysfunction in almost all critically ill COVID-19 patients.…”

Section: Non-covid-19 Patientsmentioning

confidence: 99%

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Manolis¹,

Manolis

et al. 2021

J Cardiovasc Pharmacol Ther

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In the era of the coronavirus disease 2019 (COVID-19) pandemic, acute cardiac injury (ACI), as reflected by elevated cardiac troponin above the 99th percentile, has been observed in 8%-62% of patients with COVID-19 infection with highest incidence and mortality recorded in patients with severe infection. Apart from the clinically and electrocardiographically discernible causes of ACI, such as acute myocardial infarction (MI), other cardiac causes need to be considered such as myocarditis, Takotsubo syndrome, and direct injury from COVID-19, together with noncardiac conditions, such as pulmonary embolism, critical illness, and sepsis. Acute coronary syndromes (ACS) with normal or near-normal coronary arteries (ACS-NNOCA) appear to have a higher prevalence in both COVID-19 positive and negative patients in the pandemic compared to the pre-pandemic era. Echocardiography, coronary angiography, chest computed tomography and/or cardiac magnetic resonance imaging may render a correct diagnosis, obviating the need for endomyocardial biopsy. Importantly, a significant delay has been recorded in patients with ACS seeking advice for their symptoms, while their routine care has been sharply disrupted with fewer urgent coronary angiographies and/or primary percutaneous coronary interventions performed in the case of ST-elevation MI (STEMI) with an inappropriate shift toward thrombolysis, all contributing to a higher complication rate in these patients. Thus, new challenges have emerged in rendering a diagnosis and delivering treatment in patients with ACI/ACS in the pandemic era. These issues, the various mechanisms involved in the development of ACI/ACS, and relevant current guidelines are herein reviewed.

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Section: Non-covid-19 Patientsmentioning

confidence: 99%

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Manolis¹,

Manolis

et al. 2021

J Cardiovasc Pharmacol Ther

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“…The COVID-19 pandemic is related to a higher incidence of myocarditis and general CMRi diagnostic criteria for the diagnosis of myocarditis has been well defined recently and include detection and quantization of non-ischemic myocardial edema on T2 mapping and TIR/T2 weighted, native T1, as well as extracellular volume and LGE sequences for inflammatory injury [3,4]; more specifically, the central role of CMRi and its use in the Covid 19 disease management pathway has been defined as well [5]. The evaluation of the right ventricle in the context of cardiac imaging has always been a challenging area; the introduction of CMRi allowed a clearly more accurate definition of the morphology and function of the right ventricle in comparison to the tests available up until its advent [6][7][8].…”

Section: ' Discussionmentioning

confidence: 99%

Accordion sign in COVID 19 related acute myocarditis, an old sign for a novel context? A cardiac magnetic resonance case series report study

Mangini¹,

Bruno²,

Biederman³

et al. 2022

Arch Clin Cases

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INTRODUCTION: The COVID-19 pandemic is related to a higher incidence of myocarditis; we present a case series of seven patients, admitted with COVID-19 related acute myocarditis, evaluated with cardiac magnetic resonance imaging, showing an altered profile of the free wall of the right ventricle, no longer present after six months follow-up. MATERIALS AND METHODS: Seven patients have been evaluated for COVID-19 related acute myocarditis, all patients have been evaluated with cardiac magnetic resonance imaging both in the acute setting and after six months follow-up. RESULTS: In the acute phase, myocarditis was confirmed in keeping with the current diagnostic criteria. In five out of seven cases, the presence of a crinkling profile of the free wall of the right ventricle was observed; at six months follow up, remission in four out of the five cases and a significant reduction in the remaining case, of the previously described findings, was observed. CONCLUSIONS: Crinkling appearance in the profile of the free wall of the right ventricle, detectable with cardiac magnetic resonance imaging, might represent a morphological feature present in the acute setting of COVID-19 related myocarditis; several underlying physiopathological mechanisms are conceivable. Further studies are needed to confirm this correlation, define the underlying mechanisms and the prognostic implication related to it. This is the first report in the literature that has considered such findings to the best of our knowledge.

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“…Key findings in COVID-19 myocarditis include myocardial edema, myocardial necrosis, LGE, and RV dysfunction [ 135 ]. Panchal et al reported that, from their experience, CMR demonstrated more diffuse myocardial involvement in COVID-19-related myocarditis as compared to non-COVID-19 myocarditis [ 136 ].…”

Section: Imaging In Covid-19mentioning

confidence: 99%

A Review of the Role of Imaging Modalities in the Evaluation of Viral Myocarditis with a Special Focus on COVID-19-Related Myocarditis

et al. 2022

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Viral myocarditis is inflammation of the myocardium secondary to viral infection. The clinical presentation of viral myocarditis is very heterogeneous and can range from nonspecific symptoms of malaise and fatigue in subclinical disease to a more florid presentation, such as acute cardiogenic shock and sudden cardiac death in severe cases. The accurate and prompt diagnosis of viral myocarditis is very challenging. Endomyocardial biopsy is considered to be the gold standard test to confirm viral myocarditis; however, it is an invasive procedure, and the sensitivity is low when myocardial involvement is focal. Cardiac imaging hence plays an essential role in the noninvasive evaluation of viral myocarditis. The current coronavirus disease 2019 (COVID-19) pandemic has generated considerable interest in the use of imaging in the early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related myocarditis. This article reviews the role of various cardiac imaging modalities used in the diagnosis and assessment of viral myocarditis, including COVID-19-related myocarditis.

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Contemporary use of cardiac imaging for COVID-19 patients: a three center experience defining a potential role for cardiac MRI

Cited by 10 publications

References 54 publications

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

COVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges

Accordion sign in COVID 19 related acute myocarditis, an old sign for a novel context? A cardiac magnetic resonance case series report study

A Review of the Role of Imaging Modalities in the Evaluation of Viral Myocarditis with a Special Focus on COVID-19-Related Myocarditis

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