Cohort study

Myocardial Injury on Cardiac Magnetic Resonance (CMR) in Patients With COVID-19 and Suspected Cardiac Involvement

JACC Cardiovasc ImagingPublished

  • Retrospective cohort study
  • multicentre
  • 18 international sites

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)

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)

ComparisonOR (95% CI)P value
Chest discomfort · univariate analysis2.00 (1.17–3.40)P = 0.01
Abnormal ECG · univariate analysis1.90 (1.12–3.23)P = 0.02
Natriuretic peptide elevation · univariate analysis2.99 (1.60–5.58)P = 0.0006
Troponin elevation · univariate analysis4.21 (2.41–7.36)P < 0.0001

Variables associated with acute ischemic patterns (univariate)

ComparisonOR (95% CI)P value
Chest discomfort · univariate analysis3.14 (1.04–9.49)P = 0.04
Abnormal ECG · univariate analysis4.06 (1.10–14.92)P = 0.04
Known coronary disease · univariate analysis33.30 (4.04–274.53)P = 0.001
Hospitalization · univariate analysis4.98 (1.55–16.05)P = 0.007
Natriuretic peptide elevation · univariate analysis4.19 (1.30–13.51)P = 0.02
Troponin elevation · univariate analysis25.27 (5.55–115.03)P < 0.0001

Troponin elevation and acute myocarditis patterns (multivariate)

ComparisonOR (95% CI)P value
Troponin elevation · multivariate analysis4.98 (1.76–14.05)P = 0.003

Original publication

Myocardial Injury on CMR in Patients With COVID-19 and Suspected Cardiac Involvement. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.1016/j.jcmg.2022.10.021

Summarised from the published abstract; every number is checked against it