Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis.
Eur J Pediatr
; 181(7): 2879-2883, 2022 Jul.
Article
in English
| MEDLINE | ID: covidwho-1813679
ABSTRACT
Myocarditis is a rare complication of the COVID-19 mRNA vaccine. We previously reported a case series of 15 adolescents with vaccine-associated myocarditis, 87% of whom had abnormalities on initial cardiac magnetic resonance (CMR), including late gadolinium enhancement (LGE) in 80%. We performed follow-up CMRs to determine the trajectory of myocardial recovery and better understand the natural history of vaccine-associated myocarditis. Case series of patients age < 19 years admitted to Boston Children's Hospital with acute vaccine-associated myocarditis following the BNT162b2 vaccine who had abnormal CMR at the time of initial presentation, and underwent follow-up testing. CMR assessment included left ventricular (LV) ejection fraction, T2-weighted myocardial imaging, LV global native T1, LV global T2, extracellular volume (ECV), and late gadolinium enhancement (LGE). Ten patients (9 male, median age 15 years) with vaccine-associated myocarditis underwent follow-up CMR at a median of 92 days (range 76-119) after hospital discharge. LGE was persistent in 80% of patients, though improved from prior in all cases. Two patients (20%) had abnormal LV global T1 at presentation, which normalized on follow-up. ECV decreased between acute presentation and follow-up in 6/10 patients; it remained elevated at follow-up in 1 patient and borderline in 3 patients. CONCLUSION:
CMR performed ~3 months after admission for COVID-19 vaccine-associated myocarditis showed improvement of LGE in all patients, but persistent in the majority. Follow-up CMR 6-12 months after acute episode should be considered to better understand the long-term cardiac risks. WHAT IS KNOWN ⢠Myocarditis is a rare side effect of COVID-19 mRNA vaccine. â¢Late gadolinium enhancement is present on most cardiac magnetic resonance at the time of acute presentation. WHAT IS NEW â¢Late gadolinium enhancement improved on all repeat cardiac magnetic resonance at 3-month follow-up. â¢Most patients still had a small amount of late gadolinium enhancement, the clinical significance of which is yet to be determined.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Myocarditis
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Adolescent
/
Adult
/
Child
/
Humans
/
Male
/
Young adult
Language:
English
Journal:
Eur J Pediatr
Year:
2022
Document Type:
Article
Affiliation country:
S00431-022-04482-z
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