Key result
Vaccine-associated myocarditis and pericarditis following COVID-19 vaccination generally present with a mild, self-limiting clinical course and resolution of active inflammation on cardiac MRI at short-term follow-up.
Why the study?
Clinical and cardiac magnetic resonance short-term follow-up in patients with myocarditis, pericarditis, or myo-pericarditis following COVID-19 vaccination required evaluation.
Observational (n=44)
Yes
Vaccine-associated myocarditis and pericarditis following COVID-19 vaccination generally have a mild clinical course with resolution of active inflammation on CMR at short-term follow-up, though late gadolinium enhancement often persists.
Answers are grounded in this paper and cite their sources.
Suggests favorable short-term VAMP outcomes with CMR resolution in most; leaves open long-term prognosis and management needs.
To evaluate clinical and cardiac magnetic resonance (CMR) short-term follow-up (FU) in patients with vaccine-associated myocarditis, pericarditis or myo-pericarditis (VAMP) following COVID-19 vaccination. We retrospectively analyzed 44 patients (2 women, mean age: 31.7 ± 15.1 years) with clinical and CMR manifestations of VAMP, recruited from 13 large tertiary national centers. Inclusion criteria were troponin raise, interval between the last vaccination dose and onset of symptoms < 25 days and symptoms-to-CMR < 20 days. 29/44 patients underwent a short-term FU-CMR with a median time of 3.3 months. Ventricular volumes and CMR findings of cardiac injury were collected in all exams. Mean interval between the last vaccination dose and the onset of symptoms was 6.2 ± 5.6 days. 30/44 patients received a vaccination with Comirnaty, 12/44 with Spikevax, 1/44 with Vaxzevria and 1/44 with Janssen (18 after the first dose of vaccine, 20 after the second and 6 after the "booster" dose). Chest pain was the most frequent symptom (41/44), followed by fever (29/44), myalgia (17/44), dyspnea (13/44) and palpitations (11/44). At baseline, left ventricular ejection fraction (LV-EF) was reduced in 7 patients; wall motion abnormalities have been detected in 10. Myocardial edema was found in 35 (79.5%) and LGE in 40 (90.9%) patients. Clinical FU revealed symptoms persistence in 8/44 patients. At FU-CMR, LV-EF was reduced only in 2 patients, myocardial edema was present in 8/29 patients and LGE in 26/29. VAMPs appear to have a mild clinical presentation, with self-limiting course and resolution of CMR signs of active inflammation at short-term follow-up in most of the cases.
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Galea et al. (2023) conducted an observational in Vaccine-associated myocarditis, pericarditis or myo-pericarditis (VAMP) (n=44). COVID-19 vaccination was evaluated on Clinical and CMR features at short-term follow-up. Vaccine-associated myocarditis and pericarditis following COVID-19 vaccination generally present with a mild, self-limiting clinical course and resolution of active inflammation on cardiac MRI at short-term follow-up.
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