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Cardiac magnetic resonance findings in acute and post-acute COVID-19 patients with suspected myocarditis.
Palmisano, Anna; Vignale, Davide; Bruno, Elisa; Peretto, Giovanni; De Luca, Giacomo; Campochiaro, Corrado; Tomelleri, Alessandro; Agricola, Eustachio; Montorfano, Matteo; Esposito, Antonio.
  • Palmisano A; Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Vignale D; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Bruno E; Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Peretto G; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • De Luca G; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Campochiaro C; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Tomelleri A; Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Agricola E; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Montorfano M; Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Esposito A; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
J Clin Ultrasound ; 51(4): 613-621, 2023 May.
Article in English | MEDLINE | ID: covidwho-2301433
ABSTRACT

INTRODUCTION:

Cardiac injury is commonly reported in COVID-19 patients, resulting associated to pre-existing cardiovascular disease, disease severity, and unfavorable outcome. Aim is to report cardiac magnetic resonance (CMR) findings in patients with myocarditis-like syndrome during the acute phase of SARS-CoV-2 infection (AMCovS) and post-acute phase (cPACS).

METHODS:

Between September 2020 and January 2022, 39 consecutive patients (24 males, 58%) were referred to our department to perform a CMR for the suspicion of myocarditis related to AMCovS (n = 17) and cPACS (n = 22) at multimodality evaluation (clinical, laboratory, ECG, and echocardiography). CMR was performed for the assessment of volume, function, edema and fibrosis with standard sequences and mapping techniques. CMR diagnosis and the extension and amount of CMR alterations were recorded.

RESULTS:

Patients with suspected myocarditis in acute and post-COVID settings were mainly men (10 (59%) and 12 (54.5%), respectively) with older age in AMCovS (58 [48-64]) compared to cPACS (38 [26-53]). Myocarditis was confirmed by CMR in most of cases 53% of AMCovS and 50% of cPACS with negligible LGE burden (3 [IQR, 1-5] % and 2 [IQR, 1-4] %, respectively). Myocardial infarction was identified in 4/17 (24%) patients with AMCovS. Cardiomyopathies were identified in 12% (3/17) and 27% (6/22) of patients with AMCovS and cPACS, including DCM, HCM and mitral valve prolapse.

CONCLUSIONS:

In patients with acute and post-acute COVID-19 related suspected myocarditis, CMR improves diagnostic accuracy characterizing ischemic and non-ischemic injury and unraveling subclinical cardiomyopathies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Cardiomyopathies / Myocarditis Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Clin Ultrasound Year: 2023 Document Type: Article Affiliation country: Jcu.23416

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Cardiomyopathies / Myocarditis Type of study: Diagnostic study / Experimental Studies / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: J Clin Ultrasound Year: 2023 Document Type: Article Affiliation country: Jcu.23416