Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement

被引：16

作者：

Vidula, Mahesh K. ^{[1
]}

Rajewska-Tabor, Justyna ^{[2
]}

Cao, J. Jane ^{[3
]}

Kang, Yu ^{[1
]}

Craft, Jason ^{[3
]}

Mei, Winifred ^{[3
]}

Chandrasekaran, Preethi S. ^{[4
]}

Clark, Daniel E. ^{[5
]}

Poenar, Ana-Maria ^{[6
]}

Gorecka, Miroslawa ^{[6
]}

Malahfji, Maan ^{[7
]}

Cowan, Eilidh ^{[7
]}

Kwan, Jennifer M. ^{[8
]}

Reinhardt, Samuel W. ^{[8
]}

Al-Tabatabaee, Sarah ^{[9
]}

Doeblin, Patrick ^{[9
]}

Villa, Adriana D. M. ^{[10
]}

Karagodin, Ilya ^{[11
]}

Alvi, Nazia ^{[11
]}

Christia, Panagiota ^{[12
]}

Spetko, Nicholas ^{[13
]}

Cassar, Mark Philip ^{[14
]}

Park, Christine ^{[15
]}

Nambiar, Lakshmi ^{[15
]}

Turgut, Alper ^{[16
]}

Azad, Mahan Roosta ^{[17
]}

Lambers, Moritz ^{[17
]}

Wong, Timothy C. ^{[18
]}

Salerno, Michael ^{[16
]}

Kim, Jiwon ^{[15
]}

Elliott, Michael ^{[19
]}

Raman, Betty ^{[14
]}

Neubauer, Stefan ^{[14
]}

Tsao, Connie W. ^{[13
]}

LaRocca, Gina ^{[12
]}

Patel, Amit R. ^{[11
]}

Chiribiri, Amedeo ^{[10
]}

Kelle, Sebastian ^{[9
]}

Baldassarre, Lauren A. ^{[8
]}

Shah, Dipan J. ^{[7
]}

Hughes, Sean G. ^{[5
]}

Tong, Matthew S. ^{[4
]}

Pyda, Malgorzata ^{[2
]}

Simonetti, Orlando P. ^{[4
]}

Plein, Sven ^{[6
]}

Han, Yuchi ^{[1
,4
,20
]}

机构：

[1] Univ Penn, Div Cardiovasc Med, Philadelphia, PA USA

[2] Univ Med Sci, Dept Magnet Resonance, Clin Cardiol 1, Poznan, Poland

[3] St Francis Hosp, Roslyn, NY USA

[4] Ohio State Univ, Div Cardiol, Columbus, OH USA

[5] Vanderbilt Univ, Div Cardiol, Med Ctr, Nashville, TN USA

[6] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Biomed Imaging Sci Dept, Leeds, England

[7] Houston Methodist Heart & Vasc Ctr, Houston, TX USA

[8] Yale Sch Med, Dept Internal Med, Cardiovasc Sect, New Haven, CT USA

[9] German Heart Ctr Berlin, Dept Internal Med Cardiol, Berlin, Germany

[10] Kings Coll London, Fac Life Sci & Med, Sch Biomed Engn & Imaging Sci, London, England

[11] Univ Chicago Med, Dept Med, Sect Cardiol, Chicago, IL USA

[12] Icahn Sch Med Mt Sinai, New York, NY USA

[13] Beth Israel Deaconess Med Ctr, Dept Med, Cardiovasc Div, Boston, MA USA

[14] Univ Oxford, Natl Inst Hlth Res NIHR, Oxford Biomed Res Ctr BRC, Radcliffe Dept Med,Div Cardiovasc Med, Oxford, England

[15] Weill Cornell Med, Dept Med, Div Cardiol, New York, NY USA

[16] Univ Virginia Hlth Syst, Dept Med, Cardiovasc Div, Charlottesville, VA USA

[17] Contilia Heart & Vasc Ctr Elisabeth Krankenhaus, Dept Cardiol & Angiol, Essen, Germany

[18] Univ Pittsburgh, Dept Med, Div Cardiol, Pittsburgh, PA USA

[19] Atrium Hlth, Sanger Heart & Vasc Inst, Charlotte, NC USA

[20] Ohio State Univ, Biomed Res Tower,Room 216,460 West 12th Ave, Columbus, OH 43210 USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2023年 / 16卷 / 05期

关键词：

cardiac magnetic resonance (CMR); COVID-2019; myocardial injury; INFARCTION;

D O I：

10.1016/j.jcmg.2022.10.021

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Myocardial injury in patients with COVID-19 and suspected cardiac involvement is not well understood.OBJECTIVES The purpose of this study was to characterize myocardial injury in a multicenter cohort of patients with COVID-19 and suspected cardiac involvement referred for cardiac magnetic resonance (CMR).METHODS This retrospective study consisted of 1,047 patients from 18 international sites with polymerase chain reaction-confirmed COVID-19 infection who underwent CMR. Myocardial injury was characterized as acute myocarditis, nonacute/nonischemic, acute ischemic, and nonacute/ischemic patterns on CMR.RESULTS In this cohort, 20.9% of patients had nonischemic injury patterns (acute myocarditis: 7.9%; nonacute/ nonischemic: 13.0%), and 6.7% of patients had ischemic injury patterns (acute ischemic: 1.9%; nonacute/ischemic: 4.8%). In a univariate analysis, variables associated with acute myocarditis patterns included chest discomfort (OR: 2.00; 95% CI: 1.17-3.40, P = 0.01), abnormal electrocardiogram (ECG) (OR: 1.90; 95% CI: 1.12-3.23; P = 0.02), natriuretic peptide elevation (OR: 2.99; 95% CI: 1.60-5.58; P = 0.0006), and troponin elevation (OR: 4.21; 95% CI: 2.41-7.36; P < 0.0001). Variables associated with acute ischemic patterns included chest discomfort (OR: 3.14; 95% CI: 1.04-9.49; P = 0.04), abnormal ECG (OR: 4.06; 95% CI: 1.10-14.92; P = 0.04), known coronary disease (OR: 33.30; 95% CI: 4.04-274.53; P = 0.001), hospitalization (OR: 4.98; 95% CI: 1.55-16.05; P = 0.007), natriuretic peptide elevation (OR: 4.19; 95% CI: 1.30-13.51; P = 0.02), and troponin elevation (OR: 25.27; 95% CI: 5.55-115.03; P < 0.0001). In a multivariate analysis, troponin elevation was strongly associated with acute myocarditis patterns (OR: 4.98; 95% CI: 1.76-14.05; P = 0.003).CONCLUSIONS In this multicenter study of patients with COVID-19 with clinical suspicion for cardiac involvement referred for CMR, nonischemic and ischemic patterns were frequent when cardiac symptoms, ECG abnormalities, and cardiac biomarker elevations were present. (J Am Coll Cardiol Img 2023;16:609-624) & COPY; 2023 by the American College of Cardiology Foundation.

引用

页码：609 / 624

页数：16

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