Long-Term Follow-Up of Cardiac MRI Findings in MIS-C

Research Article| September 01 2025 Long-Term Follow-Up of Cardiac MRI Findings in MIS-C Available to Purchase AAP Grand Rounds (2025) 54 (3): 31. https://doi.org/10.1542/gr.54-3-31 Views Icon Views Open Menu Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook X LinkedIn Email Tools Icon Tools Open Menu Get Permissions Cite Icon Cite Search Site Citation Long-Term Follow-Up of Cardiac MRI Findings in MIS-C. AAP Grand Rounds September 2025; 54 (3): 31. https://doi.org/10.1542/gr.54-3-31 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cardiac mri, pediatric inflammatory multisystem syndrome, myocarditis Source: Lang SM, Truong DT, Powell AJ, et al. CMR findings in the long-term outcomes after multisystem inflammatory syndrome in children (MUSIC) study. Circ Cardiovasc Imaging. 2025 Apr 4:e017420; doi: https://doi.org/10.1161/CIRCIMAGING.124.017420.Google Scholar Investigators from multiple institutions conducted a prospective observational study to evaluate cardiac outcomes in children with Multisystem Inflammatory Syndrome in Children (MIS-C). Study participants were patients ≤21 years old who were diagnosed with MIS-C at 1 of 32 centers in North America and had a cardiac MRI (CMR) performed. The diagnosis of MIS-C was based on the 2020 CDC definition. Although the decision to obtain a CMR and the timing of the study were left to the discretion of providers at each participating center, it was anticipated that most CMRs would be obtained 1–6 months after onset of illness in children with moderate or worse ventricular function dysfunction (left ventricular [LV] ejection fraction, <45%) on echocardiogram at presentation. The main study outcomes were ventricular dysfunction, myocarditis, and coronary artery dilation present on CMR. Standardized criteria were used for each of these outcomes. For the primary analyses, the results of the initial CMR, performed anytime between hospital admission and 1 year following onset of symptoms, were used. The rates of outcomes in patients with CMRs performed at specific time points also were calculated. A total of 255 children with MIS-C were included in the analyses. The mean age of study participants at the time of hospitalization was 11.4 ±4.4 years. The mean hospital length of stay was 8 ±7 days, and 81% of patients required ICU management. A total of 263 CMR were obtained on the 255 study children. Overall, 33.1% of CMR were performed 3 months after onset of symptoms and 45.2% approximately 6 months following symptom onset. At the time of the first CMR in patients, LV dysfunction was present in 17 (6.7%) children. The rate of LV dysfunction was 6.9% and 4.2%, respectively, in CMRs performed 3 and 6 months after MIS-C symptom onset. There were 9 (3.5%) patients who met criteria for myocarditis on their first CMR; in 15 children, the CMR findings were classified as indeterminate. Rates of myocarditis were 1.1% in CMRs performed 3 months following onset of MIS-C symptoms and 2.5% in CMRs performed 6 months after symptom onset. Coronary artery dilation could be evaluated in 174 children. Among these patients, 7.5% had coronary artery dilation visible on their first CMR. Among those with CMRs 3 and 6 months post symptom onset, coronary artery dilation was present in 6.6% and 9.3%, respectively. The authors conclude the prevalence of LV dysfunction and myocarditis in children following hospitalization for MIS-C was low. Dr Philip has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. MIS-C secondary to COVID-19 infection in previously healthy children can result in myocarditis (inflammation of the myocardium) as evidenced by troponin leak, left ventricular dysfunction... You do not currently have access to this content.