tetano
Editor, Senior Moderator
JACC Cardiovasc Imaging
. 2024 Aug 14:S1936-878X(24)00243-2.
doi: 10.1016/j.jcmg.2024.06.008. Online ahead of print. Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study
Hunain Shiwani[SUP] 1 [/SUP], Jessica Artico[SUP] 1 [/SUP], James C Moon[SUP] 1 [/SUP], Miroslawa Gorecka[SUP] 2 [/SUP], Gerry P McCann[SUP] 3 [/SUP], Giles Roditi[SUP] 4 [/SUP], Andrew Morrow[SUP] 4 [/SUP], Kenneth Mangion[SUP] 4 [/SUP], Elena Lukaschuk[SUP] 5 [/SUP], Mayooran Shanmuganathan[SUP] 5 [/SUP], Christopher A Miller[SUP] 6 [/SUP], Amedeo Chiribiri[SUP] 7 [/SUP], Mohammed Alzahir[SUP] 1 [/SUP], Sara Ramirez[SUP] 1 [/SUP], Andrew Lin[SUP] 1 [/SUP], Peter P Swoboda[SUP] 2 [/SUP], Adam K McDiarmid[SUP] 8 [/SUP], Robert Sykes[SUP] 4 [/SUP], Trisha Singh[SUP] 9 [/SUP], Chiara Bucciarelli-Ducci[SUP] 10 [/SUP], Dana Dawson[SUP] 11 [/SUP], Marianna Fontana[SUP] 12 [/SUP], Charlotte Manisty[SUP] 1 [/SUP], Thomas A Treibel[SUP] 1 [/SUP], Eylem Levelt[SUP] 2 [/SUP], Ranjit Arnold[SUP] 3 [/SUP], Robin Young[SUP] 13 [/SUP], Alex McConnachie[SUP] 13 [/SUP], Stefan Neubauer[SUP] 5 [/SUP], Stefan K Piechnik[SUP] 5 [/SUP], Rhodri H Davies[SUP] 1 [/SUP], Vanessa M Ferreira[SUP] 5 [/SUP], Marc R Dweck[SUP] 9 [/SUP], Colin Berry[SUP] 4 [/SUP], John P Greenwood[SUP] 14 [/SUP]; OxAMI Study Investigators; COVID-HEART Investigators
Collaborators, Affiliations
Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.
Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.
Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.
Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001).
Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920).
Keywords: COVID-19; cardiovascular diseases; coronavirus; magnetic resonance imaging; myocardial infarction; troponin.
. 2024 Aug 14:S1936-878X(24)00243-2.
doi: 10.1016/j.jcmg.2024.06.008. Online ahead of print. Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study
Hunain Shiwani[SUP] 1 [/SUP], Jessica Artico[SUP] 1 [/SUP], James C Moon[SUP] 1 [/SUP], Miroslawa Gorecka[SUP] 2 [/SUP], Gerry P McCann[SUP] 3 [/SUP], Giles Roditi[SUP] 4 [/SUP], Andrew Morrow[SUP] 4 [/SUP], Kenneth Mangion[SUP] 4 [/SUP], Elena Lukaschuk[SUP] 5 [/SUP], Mayooran Shanmuganathan[SUP] 5 [/SUP], Christopher A Miller[SUP] 6 [/SUP], Amedeo Chiribiri[SUP] 7 [/SUP], Mohammed Alzahir[SUP] 1 [/SUP], Sara Ramirez[SUP] 1 [/SUP], Andrew Lin[SUP] 1 [/SUP], Peter P Swoboda[SUP] 2 [/SUP], Adam K McDiarmid[SUP] 8 [/SUP], Robert Sykes[SUP] 4 [/SUP], Trisha Singh[SUP] 9 [/SUP], Chiara Bucciarelli-Ducci[SUP] 10 [/SUP], Dana Dawson[SUP] 11 [/SUP], Marianna Fontana[SUP] 12 [/SUP], Charlotte Manisty[SUP] 1 [/SUP], Thomas A Treibel[SUP] 1 [/SUP], Eylem Levelt[SUP] 2 [/SUP], Ranjit Arnold[SUP] 3 [/SUP], Robin Young[SUP] 13 [/SUP], Alex McConnachie[SUP] 13 [/SUP], Stefan Neubauer[SUP] 5 [/SUP], Stefan K Piechnik[SUP] 5 [/SUP], Rhodri H Davies[SUP] 1 [/SUP], Vanessa M Ferreira[SUP] 5 [/SUP], Marc R Dweck[SUP] 9 [/SUP], Colin Berry[SUP] 4 [/SUP], John P Greenwood[SUP] 14 [/SUP]; OxAMI Study Investigators; COVID-HEART Investigators
Collaborators, Affiliations
- PMID: 39207330
- DOI: 10.1016/j.jcmg.2024.06.008
Background: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.
Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.
Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.
Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001).
Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920).
Keywords: COVID-19; cardiovascular diseases; coronavirus; magnetic resonance imaging; myocardial infarction; troponin.