Myocardial Injury on Cardiac Magnetic Resonance (CMR) in Patients With COVID-19 and Suspected Cardiac Involvement
Authors' conclusion
In this multicenter study of patients with COVID-19 with clinical suspicion for cardiac involvement referred for CMR, nonischemic and ischemic patterns were frequent when cardiac symptoms, ECG abnormalities, and cardiac biomarker elevations were present.
Study context
- Population
- Patients with PCR-confirmed COVID-19 and suspected cardiac involvement referred for CMR
- Participants
- 1,047 patients
- Outcome
- Myocardial injury patterns on CMR (acute myocarditis, nonacute/nonischemic, acute ischemic, nonacute/ischemic)
Methodological detailsmulticentre, 18 international sites
- Multicentre
- 18 international sites
Main finding
As reported in the abstract
Myocardial injury patterns on CMR
- Nonischemic injury patterns
- 20.9%
- Acute myocarditis pattern
- 7.9%
- Nonacute/nonischemic pattern
- 13.0%
- Ischemic injury patterns
- 6.7%
- Acute ischemic pattern
- 1.9%
- Nonacute/ischemic pattern
- 4.8%
Observational data: associations, not effects.
Further findings
Variables associated with acute myocarditis patterns (univariate)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Chest discomfortUnivariate analysis | 2.00 (1.17–3.40) | P = 0.01 | |
| Abnormal ECGUnivariate analysis | 1.90 (1.12–3.23) | P = 0.02 | |
| Natriuretic peptide elevationUnivariate analysis | 2.99 (1.60–5.58) | P = 0.0006 | |
| Troponin elevationUnivariate analysis | 4.21 (2.41–7.36) | P < 0.0001 | |
| 0.10.31310Odds ratio (log scale) |
Variables associated with acute ischemic patterns (univariate)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Chest discomfortUnivariate analysis | 3.14 (1.04–9.49) | P = 0.04 | |
| Abnormal ECGUnivariate analysis | 4.06 (1.10–14.92) | P = 0.04 | |
| Known coronary diseaseUnivariate analysis | 33.30 (4.04–274.53) | P = 0.001 | |
| HospitalizationUnivariate analysis | 4.98 (1.55–16.05) | P = 0.007 | |
| Natriuretic peptide elevationUnivariate analysis | 4.19 (1.30–13.51) | P = 0.02 | |
| Troponin elevationUnivariate analysis | 25.27 (5.55–115.03) | P < 0.0001 | |
| 0.050.21520Odds ratio (log scale) |
Troponin elevation and acute myocarditis patterns (multivariate)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Troponin elevationMultivariate analysis | 4.98 (1.76–14.05) | P = 0.003 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.
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