In patients with COVID-19 vaccine-related myopericarditis, left ventricular longitudinal strain significantly improved from a median of -18.6% at initial presentation to -20.8% at a median 44-day follow-up (p=0.004), indicating myocardial recovery.
Cohort (n=20)
No
In patients with myopericarditis following mRNA COVID-19 vaccination, abnormal left ventricular longitudinal strain during acute illness improves longitudinally, indicating myocardial recovery.
Absolute Event Rate: -20.8% vs -18.6%
p-value: p=0.004
Abstract Background Multiple reports have described myopericarditis following mRNA COVID-19 vaccination. However, data on the persistence of subclinical myocardial injury assessed by left ventricular (LV) longitudinal strain (LVLS) is limited. Objectives Our aim was to assess LV function longitudinally in our cohort of COVID-19 vaccine-related myopericarditis using ejection fraction (EF), fractional shortening (FS), LVLS, and diastolic parameters. Methods Retrospective, single-center review of demographic, laboratory, and management data was performed on 20 patients meeting diagnostic criteria for myopericarditis after mRNA COVID-19 vaccination. Echocardiographic images were obtained on initial presentation (time 0), at a median of 12 days (7.5, 18.5; time 1), and at a median of 44 days (29.5, 83.5; time 2). FS was calculated by M-mode, EF by 5/6 area-length methods, LVLS by utilization of TOMTEC software, and diastolic function by tissue Doppler. All parameters were compared across pairs of these time points using Wilcoxon signed-rank test. Results Our cohort consisted predominantly of adolescent males (85%) with mild presentation of myopericarditis. The median EF was 61.6% (54.6, 68.0), 63.8% (60.7, 68.3), 61.4% (60.1, 64.6) at times 0, 1, and 2, respectively. Upon initial presentation, 47% of our cohort had LVLS < -18%. The median LVLS was − 18.6% (-16.9, -21.0) at time 0, -21.2% at time 1 (-19.4, -23.5) (p = 0.004) and − 20.8% (-18.7, -21.7) at time 2 (p = 0.004, as compared to time 0). Conclusions Though many of our patients had abnormal strain during acute illness, LVLS improved longitudinally, indicating myocardial recovery. LVLS can be used as marker of subclinical myocardial injury and risk stratification in this population.
Barresi et al. (Thu,) conducted a cohort in Myopericarditis after mRNA COVID-19 vaccination (n=20). COVID-19 vaccine-related myopericarditis vs. Initial presentation (baseline) was evaluated on Left ventricular longitudinal strain (LVLS) (p=0.004). In patients with COVID-19 vaccine-related myopericarditis, left ventricular longitudinal strain significantly improved from a median of -18.6% at initial presentation to -20.8% at a median 44-day follow-up (p=0.004), indicating myocardial recovery.
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