Minor myocardial scars in association with cardiopulmonary function after COVID-19.

ABSTRACT

BACKGROUND: Myocardial scars detected by cardiac magnetic resonance imaging (CMR) after COVID-19 have caused concerns regarding potential long-term cardiovascular consequences. Therefore, we wanted to investigate cardiopulmonary functioning in patients with versus without COVID-19-related myocardial scars. METHODS: In this prospective cohort study, CMR was performed approximately 6 months after moderate-to-severe COVID-19. Before (~3 months post-COVID) and after (~12 months post-COVID) the CMR, patients underwent extensive cardiopulmonary testing with cardiopulmonary exercise tests (CPET), 24-hour ECG, echocardiography, and assessment of dyspnea. We excluded participants with overt heart failure. RESULTS: 49 patients with post-COVID CMR had available cardiopulmonary tests at 3 and 12 months after the index hospitalization. Nine (18%) patients had small LGE-detected myocardial scars. Patients with myocardial scars were older (63.2±13.2 vs 56.2±13.2 years) and more frequently men (89% vs 55%) compared to those without scars. Echocardiographic measurements, arrhythmic burden, and CPET results were similar in patients with and without scars, i.e. peak oxygen uptake 82.1±11.5% vs 76.3±22.5% of predicted (p=0.46). There were no significant associations between myocardial scar and longitudinal changes in cardiopulmonary function from 3 to 12 months. CONCLUSION: Our findings imply that the presence of minor myocardial scars has limited clinical significance with respect to cardiopulmonary function after COVID-19. .