Cardiac MRI in Suspected Acute Myocarditis After COVID-19 mRNA Vaccination.
Rofo
; 194(9): 1003-1011, 2022 09.
Article
in English
| MEDLINE | ID: covidwho-1735322
ABSTRACT
PURPOSE:
To evaluate cardiac MRI characteristics in patients with suspected hypersensitivity myocarditis following mRNA COVID-19 vaccination. MATERIALS ANDMETHODS:
Patients clinically suspected of acute myocarditis after COVID-19 vaccination were retrospectively analyzed and compared against a healthy control group.âCardiac MRI protocol included parameters such as T1 and T2 relaxation times, extracellular volume (ECV), T2 signal intensity ratio, and late gadolinium enhancement (LGE). Lymph node size was assessed in the patient group on the injection side. Student t-test, analyses of variance (ANOVA) with Tukey post-hoc test, and χ2 test were used for statistical analysis.RESULTS:
20 patients with clinically suspected post-vaccine myocarditis (28â±â12 years; 12 men) and 40 controls (31â±â11 years; 25 men) were evaluated. According to the 2018 Lake Louise criteria (LLC), patients with clinically suspected myocarditis were further subdivided into an LLC-positive group (nâ=â9) and an LLC-negative group (nâ=â11). The mean time of symptom onset after vaccination was 1.1â±â1.2 days (LLC-positive) and 6.5â±â9.2 days (LLC-negative). Group differences in inflammatory variables between myocarditis patients and control subjects were more pronounced in the LLC-positive group (e.âg., T1 relaxation time 1041â±â61âms [LLC positive] vs. 1008â±â79âms [LLC-negative] vs. 970â±â25âms [control]; pâ<.001; or T2 signal intensity ratio 2.0â±â0.3 vs. 1.6â±â0.3 [LLC-negative] and vs. 1.6â±â0.3 [control], pâ=â.012). LLC-positive patients were significantly faster in receiving an MRI after initial symptom onset (8.8â±â6.1 days vs. 52.7â±â33.4 days; pâ=â.001) and had higher troponin T levels (3938â±â5850âng/l vs. 9â±â11âng/l; pâ<.001). LGE lesions were predominantly located at the subepicardium of the lateral wall. Axillary lymphadenopathy was more frequent in the LLC-positive group compared to the LLC-negative group (8/9 [89â%] vs. 0/11 [0â%], pâ<â0.001).CONCLUSION:
Vaccine-induced myocarditis should be considered in patients with acute symptom onset after mRNA vaccination, especially if elevated serum troponin T is observed. Imaging findings of vaccine-induced myocarditis are similar to virus-induced myocarditis, allowing for the use of the Lake Louise Criteria for diagnostic purposes. KEY POINTS · Vaccine-induced hypersensitivity myocarditis can be confirmed with cardiac MRI. · Especially patients with sudden onset of symptoms and elevated serum troponin T had positive cardiac MRI findings. · Cardiac MRI characteristics of vaccine-induced myocarditis are similar to those in virus-induced myocarditis. CITATION FORMAT · Kravchenko D, Isaak A, Mesropyan N etâal. Cardiac MRI in Suspected Acute Myocarditis After COVID-19 mRNA Vaccination. Fortschr Röntgenstr 2022; 194 1003â-â1011.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Myocarditis
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Young adult
Language:
English
Journal:
Rofo
Year:
2022
Document Type:
Article
Affiliation country:
A-1752-0951
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