接种 COVID-19 疫苗后临床疑似心肌炎患者的心血管磁共振成像和临床随访。

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Norain Talib, Matteo Fronza, Constantin Arndt Marschner, Paaladinesh Thavendiranathan, Gauri Rani Karur, Kate Hanneman
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引用次数: 0

摘要

背景:本研究旨在评估接种 COVID-19 疫苗后疑似心肌炎患者的心血管磁共振(CMR)结果及其与长期临床结果的关系:本研究旨在评估COVID-19疫苗接种后疑似心肌炎患者的心血管磁共振(CMR)结果及其与长期临床结果的关系:回顾性评估了 2021-2022 年间在一个中心接种基于 mRNA 的 COVID-19 疫苗后接受有临床指征的 CMR 评估疑似心肌炎的连续成年患者。根据修订后的路易斯湖标准对患者进行分类,包括基于 T1 的异常(晚期钆增强或高 T1 值)和基于 T2 的异常(区域性 T2- 高强度或高 T2 值):共纳入 89 例患者(男性占 64%,平均年龄为 34±13 岁,mRNA-1273 占 38%,BNT162b2 占 62%)。在基线 CMR 中,42 人(47%)至少有一项异常;25 人(28%)同时符合 T1 和 T2 标准;17 人(19%)符合 T1 标准,但不符合 T2 标准;47 人(53%)两项均不符合。与仅符合 T1 标准的患者(110 天,IQR 66-255,p 结论)相比,符合 T1 和 T2 标准的患者从接种疫苗到进行 CMR 的时间间隔较短(28 天,IQR 8-69):在一组因接种 COVID-19 疫苗后疑似心肌炎而接受临床指征 CMR 的患者中,47% 的患者在基线 CMR 时至少有一项异常。心肌水肿的发现与接种后进行 CMR 的时间有关。没有发生不良心脏事件。然而,48%的患者在随访时仍存在轻微的LGE。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular magnetic resonance imaging and clinical follow-up in patients with clinically suspected myocarditis after COVID-19 vaccination.

Background: The purpose of this study was to evaluate cardiovascular magnetic resonance (CMR) findings and their relationship to longer-term clinical outcomes in patients with suspected myocarditis following coronavirus disease 2019 (COVID-19) vaccination.

Methods: Consecutive adult patients who underwent clinically indicated CMR for evaluation of suspected myocarditis following messenger ribonucleic acid (mRNA)-based COVID-19 vaccination at a single center between 2021 and 2022 were retrospectively evaluated. Patients were classified based on the revised Lake Louise criteria for T1-based abnormalities (late gadolinium enhancement [LGE] or high T1 values) and T2-based abnormalities (regional T2-hyperintensity or high T2 values).

Results: Eighty-nine patients were included (64% [57/89] male, mean age 34 ± 13 years, 38% [32/89] mRNA-1273, and 62% [52/89] BNT162b2). On baseline CMR, 42 (47%) had at least one abnormality; 25 (28%) met both T1- and T2-criteria; 17 (19%) met T1-criteria but not T2-criteria; and 47 (53%) did not meet either. The interval between vaccination and CMR was shorter in those who met T1- and T2-criteria (28 days, IQR 8-69) compared to those who met T1-criteria only (110 days, IQR 66-255, p < 0.001) and those who did not meet either (120 days, interquartile range (IQR) 80-252, p < 0.001). In the subset of 21 patients who met both T1- and T2-criteria at baseline and had follow-up CMR, myocardial edema had resolved and left ventricular ejection fraction had normalized in all at median imaging follow-up of 214 days (IQR 132-304). However, minimal LGE persisted in 10 (48%). At median clinical follow-up of 232 days (IQR 156-405, n = 60), there were no adverse cardiac events. However, mild cardiac symptoms persisted in 7 (12%).

Conclusion: In a cohort of patients who underwent clinically indicated CMR for suspected myocarditis following COVID-19 vaccination, 47% had at least one abnormality at baseline CMR. Detection of myocardial edema was associated with the timing of CMR after vaccination. There were no adverse cardiac events. However, minimal LGE persisted in 48% at follow-up.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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