Key result
Post-COVID-19 status is linked to higher myocardial T2 mapping values, indicating persistent myocardial oedema.
Why the study?
Post-COVID-19 patients may have myocardial involvement secondary to systemic inflammation, but detection using CMR mapping and feature tracking is not well characterized.
Does cardiac magnetic resonance imaging detect persistent myocardial involvement in recovering COVID-19 patients compared to healthy controls?
Observational (n=77)
Does cardiac magnetic resonance imaging detect persistent myocardial involvement in recovering COVID-19 patients compared to healthy controls?
Absolute Event Rate: 50.9% vs 48%
p-value: p=<0.01
Recovering COVID-19 patients show evidence of myocardial oedema on CMR T2 mapping compared to healthy controls, with transiently reduced myocardial strain in the early recovery phase (<8 weeks).
Raised T2 values suggest possible oedema without strain impairment post-COVID; leaves open whether early CMR informs management in observational cohorts.
BACKGROUND: Post-COVID-19 patients may incur myocardial involvement secondary to systemic inflammation. Our aim was to detect possible oedema/diffuse fibrosis using cardiac magnetic resonance imaging (CMR) mapping and to study myocardial deformation of the left ventricle (LV) using feature tracking (FT). METHODS: Prospective analysis of consecutively recruited post-COVID-19 patients undergoing CMR. T1 and T2 mapping sequences were acquired and FT analysis was performed using 2D steady-state free precession cine sequences. Statistical significance was set to p < 0.05. RESULTS: Included were 57 post-COVID-19 patients and 20 healthy controls, mean age 59 ± 15 years, men 80.7%. The most frequent risk factors were hypertension (33.3%) and dyslipidaemia (36.8%). The contact-to-CMR interval was 81 ± 27 days. LV ejection fraction (LVEF) was 61 ± 10%. Late gadolinium enhancement (LGE) was evident in 26.3% of patients (19.3%, non-ischaemic). T2 mapping values (suggestive of oedema) were higher in the study patients than in the controls (50.9 ± 4.3 ms vs 48 ± 1.9 ms, p < 0.01). No between-group differences were observed for native T1 nor for circumferential strain (CS) or radial strain (RS) values (18.6 ± 3.3% vs 19.2 ± 2.1% (p = 0.52) and 32.3 ± 8.1% vs 33.6 ± 7.1% (p = 0.9), respectively). A sub-group analysis for the contact-to-CMR interval (<8 weeks vs ≥ 8 weeks) showed that FT-CS (15.6 ± 2.2% vs 18.9 ± 2.6%, p < 0.01) and FT-RS (24.9 ± 5.8 vs 33.5 ± 7.2%, p < 0.01) values were lower for the shorter interval. CONCLUSIONS: Post-COVID-19 patients compared to heathy controls had raised T2 values (related to oedema), but similar native T1, FT-CS and FT-RS values. FT-CS and FT-RS values were lower in post-COVID-19 patients undergoing CMR after < 8 weeks compared to ≥ 8 weeks.
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Ulloa et al. (2021) conducted an observational in Post-COVID-19 (n=77). Post-COVID-19 status vs. Healthy controls was evaluated on T2 mapping values (suggestive of oedema) (p=<0.01). Post-COVID-19 patients had higher myocardial T2 mapping values than healthy controls (50.9 vs 48.0 ms, P<0.01), indicating oedema, with no differences in native T1 or strain values.
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