Somatostatin receptor positron emission tomography/computed tomography in myocarditis following mRNA COVID-19 vaccination

Bollano, Entela; Bergh, Niklas; Dudás, Anna; Bobbio, Emanuele; Polte, Christian L.

doi:10.1093/ehjcr/ytac117

Cited by 5 publications

(2 citation statements)

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“…Among EMB diagnostics, non-invasive imaging techniques have been used to identify COVID-19-vaccine-related myocarditis [2][3][4][5][6][7]. Besides cMRI markers such as T2-weighted ratio, early gadolinium enhancement and late gadolinium enhancement within the Lake Louise criteria and somatostatin receptor positron emission tomography/computed tomography (PET/CT) have been applied for the diagnosis of myocarditis following COVID-19 vaccination [27]. However, as cardiac imaging techniques give helpful, but limited information about severe myocardial inflammation, they are unable to correlate with mild inflammation and viral persistence.…”

Section: Discussionmentioning

confidence: 99%

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Baumeier

Aleshcheva

Harms

et al. 2022

IJMS

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Myocarditis in response to COVID-19 vaccination has been reported since early 2021. In particular, young male individuals have been identified to exhibit an increased risk of myocardial inflammation following the administration of mRNA-based vaccines. Even though the first epidemiological analyses and numerous case reports investigated potential relationships, endomyocardial biopsy (EMB)-proven cases are limited. Here, we present a comprehensive histopathological analysis of EMBs from 15 patients with reduced ejection fraction (LVEF = 30 (14–39)%) and the clinical suspicion of myocarditis following vaccination with Comirnaty® (Pfizer-BioNTech) (n = 11), Vaxzevria® (AstraZenica) (n = 2) and Janssen® (Johnson & Johnson) (n = 2). Immunohistochemical EMB analyses reveal myocardial inflammation in 14 of 15 patients, with the histopathological diagnosis of active myocarditis according the Dallas criteria (n = 2), severe giant cell myocarditis (n = 2) and inflammatory cardiomyopathy (n = 10). Importantly, infectious causes have been excluded in all patients. The SARS-CoV-2 spike protein has been detected sparsely on cardiomyocytes of nine patients, and differential analysis of inflammatory markers such as CD4+ and CD8+ T cells suggests that the inflammatory response triggered by the vaccine may be of autoimmunological origin. Although a definitive causal relationship between COVID-19 vaccination and the occurrence of myocardial inflammation cannot be demonstrated in this study, data suggest a temporal connection. The expression of SARS-Cov-2 spike protein within the heart and the dominance of CD4+ lymphocytic infiltrates indicate an autoimmunological response to the vaccination.

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Section: Discussionmentioning

confidence: 99%

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Baumeier

Aleshcheva

Harms

et al. 2022

IJMS

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“…CMRI is the mainstay in the diagnostic workup and shows signs of myocardial inflammation, which are often classic in cases of viral myocarditis, especially when following mRNA COVID-19 vaccination. Myocarditis following mRNA COVID-19 vaccination could also be visualized using somatostatin receptor PET/CT, a promising method for molecular inflammation imaging [27,58]. Sarcoidosis is a systemic inflammatory disease of unknown etiology characterized by non-caseating granuloma formation [59].…”

Section: Biomarkersmentioning

confidence: 99%

Biomarkers in Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Updated Review of the Literature

Crisci,

Bobbio,

Gentile

et al. 2023

JCM

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Myocarditis is a disease caused by cardiac inflammation that can progress to dilated cardiomyopathy, heart failure, and eventually death. Several etiologies, including autoimmune, drug-induced, and infectious, lead to inflammation, which causes damage to the myocardium, followed by remodeling and fibrosis. Although there has been an increasing understanding of pathophysiology, early and accurate diagnosis, and effective treatment remain challenging due to the high heterogeneity. As a result, many patients have poor prognosis, with those surviving at risk of long-term sequelae. Current diagnostic methods, including imaging and endomyocardial biopsy, are, at times, expensive, invasive, and not always performed early enough to affect disease progression. Therefore, the identification of accurate, cost-effective, and prognostically informative biomarkers is critical for screening and treatment. The review then focuses on the biomarkers currently associated with these conditions, which have been extensively studied via blood tests and imaging techniques. The information within this review was retrieved through extensive literature research conducted on major publicly accessible databases and has been collated and revised by an international panel of experts. The biomarkers discussed in the article have shown great promise in clinical research studies and provide clinicians with essential tools for early diagnosis and improved outcomes.

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Novel Radiotracers for Molecular Imaging of Myocardial Inflammation: an Update Focused on Clinical Translation of Non-18F-FDG Radiotracers

Shi

Miller

2023

Curr Cardiovasc Imaging Rep

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Somatostatin receptor positron emission tomography/computed tomography in myocarditis following mRNA COVID-19 vaccination

Cited by 5 publications

References 0 publications

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Biomarkers in Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Updated Review of the Literature

Novel Radiotracers for Molecular Imaging of Myocardial Inflammation: an Update Focused on Clinical Translation of Non-18F-FDG Radiotracers

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