tetano
Editor, Senior Moderator
Eur Heart J Cardiovasc Imaging
. 2021 Nov 5;jeab230.
doi: 10.1093/ehjci/jeab230. Online ahead of print.
Myocarditis following COVID-19 vaccination: magnetic resonance imaging study
Arthur Shiyovich[SUP] 1 [/SUP], Guy Witberg[SUP] 1 [/SUP], Yaron Aviv[SUP] 1 [/SUP], Alon Eisen[SUP] 1 [/SUP], Katia Orvin[SUP] 1 [/SUP], Maya Wiessman[SUP] 1 [/SUP], Tzlil Grinberg[SUP] 1 [/SUP], Avital Porter[SUP] 1 [/SUP], Ran Kornowski[SUP] 1 [/SUP], Ashraf Hamdan[SUP] 1 [/SUP]
Affiliations
Abstract
Aims: To describe the cardiac magnetic resonance (CMR) imaging findings of patients who developed myocarditis following messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination.
Methods and results: The present study retrospectively evaluated patients with clinically adjudicated myocarditis within 42 days of the first Pfizer-BNT162b2 mRNA COVID-19 vaccination, between 20 December 2020 and 24 May 2021 who underwent CMR. A total of 15 out 54 patients (28%) with myocarditis underwent a CMR and were included, 100% males, median age of 32 years (interquartile range = 22.5-40). Most patients presented with chest pain (87%) and had an abnormal electrocardiogram (79%). The severity of the disease was mild in 67% and intermediate in 33%. All patients survived and one patient was readmitted during the study period. CMR was performed at a median of 65 days (range 3-130 days) following diagnosis. Median ejection fraction was 58% (range 51-74%) global- and regional wall motion abnormalities were present in one and three patients, respectively. Native T1 was available in 13/15 patients (2/3 in 3 T and 11/12 in the 1.5 T), with increased values among 6/13. Late gadolinium enhancement (LGE) was found among 13/15 patients with a median of 2% (range 0-15%) with inferolateral wall being the most common location (8/13). The patterns of the LGE were: mid-wall in six patients; epicardial in five patients; and mid-wall and epicardial in two patients.
Conclusions: Among patients who were diagnosed with post-vaccination clinical myocarditis, CMR imaging findings are mild and consistent with 'classical myocarditis'. The short-term clinical course and outcomes were favourable.
Keywords: COVID-19 vaccination; cardiac magnetic resonance; myocarditis.
. 2021 Nov 5;jeab230.
doi: 10.1093/ehjci/jeab230. Online ahead of print.
Myocarditis following COVID-19 vaccination: magnetic resonance imaging study
Arthur Shiyovich[SUP] 1 [/SUP], Guy Witberg[SUP] 1 [/SUP], Yaron Aviv[SUP] 1 [/SUP], Alon Eisen[SUP] 1 [/SUP], Katia Orvin[SUP] 1 [/SUP], Maya Wiessman[SUP] 1 [/SUP], Tzlil Grinberg[SUP] 1 [/SUP], Avital Porter[SUP] 1 [/SUP], Ran Kornowski[SUP] 1 [/SUP], Ashraf Hamdan[SUP] 1 [/SUP]
Affiliations
- PMID: 34739045
- DOI: 10.1093/ehjci/jeab230
Abstract
Aims: To describe the cardiac magnetic resonance (CMR) imaging findings of patients who developed myocarditis following messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccination.
Methods and results: The present study retrospectively evaluated patients with clinically adjudicated myocarditis within 42 days of the first Pfizer-BNT162b2 mRNA COVID-19 vaccination, between 20 December 2020 and 24 May 2021 who underwent CMR. A total of 15 out 54 patients (28%) with myocarditis underwent a CMR and were included, 100% males, median age of 32 years (interquartile range = 22.5-40). Most patients presented with chest pain (87%) and had an abnormal electrocardiogram (79%). The severity of the disease was mild in 67% and intermediate in 33%. All patients survived and one patient was readmitted during the study period. CMR was performed at a median of 65 days (range 3-130 days) following diagnosis. Median ejection fraction was 58% (range 51-74%) global- and regional wall motion abnormalities were present in one and three patients, respectively. Native T1 was available in 13/15 patients (2/3 in 3 T and 11/12 in the 1.5 T), with increased values among 6/13. Late gadolinium enhancement (LGE) was found among 13/15 patients with a median of 2% (range 0-15%) with inferolateral wall being the most common location (8/13). The patterns of the LGE were: mid-wall in six patients; epicardial in five patients; and mid-wall and epicardial in two patients.
Conclusions: Among patients who were diagnosed with post-vaccination clinical myocarditis, CMR imaging findings are mild and consistent with 'classical myocarditis'. The short-term clinical course and outcomes were favourable.
Keywords: COVID-19 vaccination; cardiac magnetic resonance; myocarditis.