Long-term effects on cardiac function and symptoms in patients with myocarditis following COVID-19 vaccination: the ECHOVID-19 Long-term Study.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Open Heart Pub Date : 2025-09-29 DOI:10.1136/openhrt-2025-003584

Mohammad Nizar Ramadan, Filip Soeskov Davidovski, Caroline Espersen, Ali Hikmat Al-Rubai, Ayat Khoraizat, Niklas Dyrby Johansen, Kristoffer Grundtvig Skaarup, Mats Christian Højbjerg Lassen, Anders Hviid, Tyra Grove, Manan Pareek, Tor Biering-Sørensen

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引用次数: 0

Abstract

Background: The long-term effects of myocarditis following COVID-19 vaccination on cardiac function and symptoms remain unclear.

Purpose: To assess the long-term effects of myocarditis following COVID-19 vaccination on cardiac function, inflammatory biomarkers and symptoms.

Methods: Patients with myocarditis within 50 days of receiving COVID-19 vaccination (2021-2022) were invited to follow-up approximately 2 years after initial hospitalisation. Follow-up assessment included echocardiography, biomarkers, ECG, lung ultrasound (LUS) and symptom questionnaires. Patients with myocarditis following COVID-19 vaccination (V-myocarditis) were compared with non-vaccine-related myocarditis (NV-myocarditis) controls admitted during the same period.

Results: 17 patients with V-myocarditis (median age 47 (27-59) years, 53% women) were included. Median time from vaccination to admission was 6 days, with 88% admitted within 30 days. At follow-up (28±6 months), patients with V-myocarditis showed mildly impaired left ventricular (LV) function (median global longitudinal strain (GLS) 16.0% (13.2%-18.2%)) and diastolic dysfunction in 71%. Right ventricular (RV) and LUS findings were preserved. Biomarkers normalised from admission to follow-up with significant reductions in troponin-I (p<0.001) and C-reactive protein (p=0.001), while 35% showed persistent low-grade inflammation. Symptoms were common at follow-up, including fatigue (35%) and chest pain (41%). Compared with NV-myocarditis, patients with V-myocarditis had similar symptoms and biomarker recovery, but lower GLS at follow-up (NV-myocarditis: 18.5% (15.4%-20.3%), p=0.04).

Conclusion: In one of the longest reported follow-up studies of myocarditis following COVID-19 vaccination, patients exhibited mild LV and diastolic dysfunction, preserved RV function and overall normalised biomarkers. A notable proportion continued reporting symptoms, highlighting the need for long-term follow-up.

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COVID-19疫苗接种对心肌炎患者心功能和症状的长期影响：ECHOVID-19长期研究

背景：COVID-19疫苗接种后心肌炎对心功能和症状的长期影响尚不清楚。目的：评估COVID-19疫苗接种后心肌炎对心功能、炎症生物标志物和症状的长期影响。方法：接受COVID-19疫苗接种后50天内（2021-2022）发生心肌炎的患者，在首次住院后约2年随访。随访评估包括超声心动图、生物标志物、心电图、肺超声（LUS）和症状问卷。将COVID-19疫苗接种后的心肌炎患者（v型心肌炎）与同期入院的非疫苗相关心肌炎（nv型心肌炎）对照进行比较。结果：纳入17例v型心肌炎患者，中位年龄47（27-59）岁，女性占53%。从接种疫苗到入院的中位时间为6天，88%在30天内入院。随访（28±6个月）时，v型心肌炎患者左室（LV）功能轻度受损（中位全纵应变（GLS）为16.0%(13.2% ~ 18.2%)），舒张功能不全占71%。右心室（RV）和左心室（LUS）的检查结果得以保留。结论：在一项报道时间最长的COVID-19疫苗接种后心肌炎随访研究中，患者表现出轻度左室和舒张功能障碍，右室功能保留，生物标志物总体正常化。显著比例的患者继续报告出现症状，这突出表明需要进行长期随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.60

自引率

3.70%

发文量

145

审稿时长

20 weeks

期刊介绍： Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.