Key result
Long COVID-19 syndrome was not associated with differences in myocardial energetics, structure, function, or perfusion compared to healthy controls, with only 1 of 20 patients showing hyperenhancement.
Why the study?
The underlying pathophysiology of long-COVID-19 syndrome remains unknown, though increased cardiometabolic demand and mitochondrial dysfunction have emerged as candidate mechanisms.
Does long COVID-19 syndrome cause abnormalities in myocardial structure, function, perfusion, or energy metabolism in previously healthy, non-hospitalized patients?
Case-Control (n=30)
Does long COVID-19 syndrome cause abnormalities in myocardial structure, function, perfusion, or energy metabolism in previously healthy, non-hospitalized patients?
In previously healthy, non-hospitalized patients with long COVID-19 syndrome, comprehensive CMR and 31P-CMRS revealed no significant abnormalities in myocardial structure, function, perfusion, or energetics compared to healthy controls, suggesting symptoms are not driven by overt cardiac pathology.
Supports absence of myocardial abnormalities in long COVID by CMR; leaves open need for larger studies to exclude subtle effects.
Background The underlying pathophysiology of post-coronavirus disease 2019 (long-COVID-19) syndrome remains unknown, but increased cardiometabolic demand and state of mitochondrial dysfunction have emerged as candidate mechanisms. Cardiovascular magnetic resonance (CMR) provides insight into pathophysiological mechanisms underlying cardiovascular disease and 31-phosphorus CMR spectroscopy ( 31 P-CMRS) allows non-invasive assessment of the myocardial energetic state. The main aim of the study was to assess whether long COVID-19 syndrome is associated with abnormalities of myocardial structure, function, perfusion and energy metabolism. Methods Prospective case–control study. A total of 20 patients with a clinical diagnosis of long COVID-19 syndrome (seropositive) and no prior underlying cardiovascular disease (CVD) and 10 matching healthy controls underwent 31 P-CMRS and CMR at 3T at a single time point. All patients had been symptomatic with acute COVID-19, but none required hospital admission. Results Between the long COVID-19 syndrome patients and matched contemporary healthy controls there were no differences in myocardial energetics (phosphocreatine to ATP ratio), in cardiac structure (biventricular volumes), function (biventricular ejection fractions , global longitudinal strain), tissue characterization (T 1 mapping and late gadolinium enhancement) or perfusion (myocardial rest and stress blood flow, myocardial perfusion reserve). One patient with long COVID-19 syndrome showed subepicardial hyperenhancement on late gadolinium enhancement imaging compatible with prior myocarditis , but no accompanying abnormality in cardiac size, function, perfusion, extracellular volume fraction, native T1, T2 or cardiac energetics. Conclusions In this prospective case–control study, the overwhelming majority of patients with a clinical long COVID-19 syndrome with no prior CVD did not exhibit any abnormalities in myocardial energetics, structure, function, blood flow or tissue characteristics.
No takes yet. Share an insight, caveat, or question.
Gorecka et al. (2022) conducted a case-control in long COVID-19 syndrome (n=30). long COVID-19 syndrome vs. healthy controls was evaluated on abnormalities of myocardial structure, function, perfusion and energy metabolism. Long COVID-19 syndrome was not associated with differences in myocardial energetics, structure, function, or perfusion compared to healthy controls, with only 1 of 20 patients showing hyperenhancement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: