Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

Püntmann, Valentina O.; Carerj, Maria Ludovica; Wieters, Imke; Fahim, Masia; Arendt, Christophe; Hoffmann, Jedrzej; Shchendrygina, Anastasia; Escher, Felicitas; Vasa‐Nicotera, Mariuca; Zeiher, Andreas M.; Vehreschild, Maria J.G.T.; Nagel, Eike

doi:10.1001/jamacardio.2020.3557

Cited by 1,927 publications

(2,343 citation statements)

References 31 publications

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“…On the other hand, a recent autopsy study shows that the presence of large amounts of the virus in the heart is accompanied by a cytokine response without inflammatory cell infiltration [32]. Cardiac magnetic resonance imaging studies on patients recovered from COVID-19 with cardiac symptoms or unexplained elevated hs-TnT confirm the absence of left ventricular systolic dysfunction and suggest a mixed mechanism showing that cardiac injury in SARS-CoV-2 infection is associated with myocardial edema and then fibrosis [33,34] with a heterogeneous pattern of late gadolinium enhancement including ischemic and non-ischemic patterns as myocarditis-like or non-specific mid-wall late gadolinium enhancement [35].…”

Section: Discussionmentioning

confidence: 98%

Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study

Lairez

Blanchard

Houard

et al. 2020

Int J Cardiovasc Imaging

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Biological cardiac injury related to the Severe Acute Respiratory Syndrome Coronavirus-2 infection has been associated with excess mortality. However, its functional impact remains unknown. The aim of our study was to explore the impact of biological cardiac injury on myocardial functions in patients with COVID-19. 31 patients with confirmed COVID-19 (CoV+) and 16 controls (CoV−) were prospectively included in this observational study. Demographic data, laboratory findings, comorbidities, treatments and myocardial function assessed by transthoracic echocardiography were collected and analysed in CoV+ with (TnT+) and without (TnT−) elevation of troponin T levels and compared with CoV−. Among CoV+, 13 (42%) exhibited myocardial injury. CoV+/TnT + patients were older, had lower diastolic arterial pressure and were more likely to have hypertension and chronic renal failure compared with CoV+/TnT−. The control group was comparable except for an absence of biological inflammatory syndrome. Left ventricular ejection fraction and global longitudinal strain were not different among the three groups. There was a trend of decreased myocardial work and increased peak systolic tricuspid annular velocity between the CoV− and CoV + patients, which became significant when comparing CoV− and CoV+/TnT+ (2167 ± 359 vs. 1774 ± 521%/mmHg, P = 0.047 and 14 ± 3 vs. 16 ± 3 cm/s, P = 0.037, respectively). There was a decrease of global work efficiency from CoV− (96 ± 2%) to CoV+/TnT− (94 ± 4%) and then CoV+/TnT+ (93 ± 3%, P = 0.042). In conclusion, biological myocardial injury in COVID 19 has low functional impact on left ventricular systolic function. Keywords COVID-19 • SARS-CoV-2 • Speckle tracking echocardiography • Strain • Myocardial work. Abbreviations CT Computed tomography hs-TnT High-sensitivity troponin T IQR Interquartile ranges LS Longitudinal strain TTE Transthoracic echocardiography RT-PCR Real-time reverse transcriptase-polymerase chain reaction SARS-CoV-2 Severe acute respiratory syndrome coronavirus-2 TAPSE Tricuspid annular plane systolic excursion

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Section: Discussionmentioning

confidence: 98%

Cardiac imaging phenotype in patients with coronavirus disease 2019 (COVID-19): results of the cocarde study

Lairez

Blanchard

Houard

et al. 2020

Int J Cardiovasc Imaging

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“…Perhaps 20% of patients admitted with covid-19 have clinically significant cardiac involvement4950; occult involvement may be even commoner 5152. Cardiopulmonary complications include myocarditis, pericarditis, myocardial infarction, dysrhythmias, and pulmonary embolus; they may present several weeks after acute covid-19.…”

Section: Supporting Recovery From Covid-19mentioning

confidence: 99%

Management of post-acute covid-19 in primary care

Greenhalgh

Knight

A’Court

et al. 2020

BMJ

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“…Valentina Puntmann, who coauthored a research paper in JAMA Cardiology examining the cardiovascular effects in unselected patients with covid-19,2 discussed one of the study’s findings: the relatively high frequency of postviral or inflammatory myocarditis in people who have had covid-19.…”

Section: Cardiovascular Effectsmentioning

confidence: 99%