tetano
Editor, Senior Moderator
Open Heart
. 2025 Sep 29;12(2):e003584.
doi: 10.1136/openhrt-2025-003584. Long-term effects on cardiac function and symptoms in patients with myocarditis following COVID-19 vaccination: the ECHOVID-19 Long-term Study
Mohammad Nizar Ramadan[SUP] 1 2 3 [/SUP], Filip Soeskov Davidovski[SUP] 4 2 3 [/SUP], Caroline Espersen[SUP] 4 2 3 [/SUP], Ali Hikmat Al-Rubai[SUP] 4 2 3 [/SUP], Ayat Khoraizat[SUP] 4 2 3 [/SUP], Niklas Dyrby Johansen[SUP] 4 2 3 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 4 2 3 [/SUP], Mats Christian Højbjerg Lassen[SUP] 4 2 3 [/SUP], Anders Hviid[SUP] 5 [/SUP], Tyra Grove[SUP] 5 [/SUP], Manan Pareek[SUP] 4 2 3 6 [/SUP], Tor Biering-Sørensen[SUP] 4 2 3 6 7 [/SUP]
Affiliations
Background: The long-term effects of myocarditis following COVID-19 vaccination on cardiac function and symptoms remain unclear.
Purpose: To assess the long-term effects of myocarditis following COVID-19 vaccination on cardiac function, inflammatory biomarkers and symptoms.
Methods: Patients with myocarditis within 50 days of receiving COVID-19 vaccination (2021-2022) were invited to follow-up approximately 2 years after initial hospitalisation. Follow-up assessment included echocardiography, biomarkers, ECG, lung ultrasound (LUS) and symptom questionnaires. Patients with myocarditis following COVID-19 vaccination (V-myocarditis) were compared with non-vaccine-related myocarditis (NV-myocarditis) controls admitted during the same period.
Results: 17 patients with V-myocarditis (median age 47 (27-59) years, 53% women) were included. Median time from vaccination to admission was 6 days, with 88% admitted within 30 days. At follow-up (28±6 months), patients with V-myocarditis showed mildly impaired left ventricular (LV) function (median global longitudinal strain (GLS) 16.0% (13.2%-18.2%)) and diastolic dysfunction in 71%. Right ventricular (RV) and LUS findings were preserved. Biomarkers normalised from admission to follow-up with significant reductions in troponin-I (p<0.001) and C-reactive protein (p=0.001), while 35% showed persistent low-grade inflammation. Symptoms were common at follow-up, including fatigue (35%) and chest pain (41%). Compared with NV-myocarditis, patients with V-myocarditis had similar symptoms and biomarker recovery, but lower GLS at follow-up (NV-myocarditis: 18.5% (15.4%-20.3%), p=0.04).
Conclusion: In one of the longest reported follow-up studies of myocarditis following COVID-19 vaccination, patients exhibited mild LV and diastolic dysfunction, preserved RV function and overall normalised biomarkers. A notable proportion continued reporting symptoms, highlighting the need for long-term follow-up.
Keywords: CARDIAC REHABILITATION; Echocardiography; Myocarditis.
. 2025 Sep 29;12(2):e003584.
doi: 10.1136/openhrt-2025-003584. Long-term effects on cardiac function and symptoms in patients with myocarditis following COVID-19 vaccination: the ECHOVID-19 Long-term Study
Mohammad Nizar Ramadan[SUP] 1 2 3 [/SUP], Filip Soeskov Davidovski[SUP] 4 2 3 [/SUP], Caroline Espersen[SUP] 4 2 3 [/SUP], Ali Hikmat Al-Rubai[SUP] 4 2 3 [/SUP], Ayat Khoraizat[SUP] 4 2 3 [/SUP], Niklas Dyrby Johansen[SUP] 4 2 3 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 4 2 3 [/SUP], Mats Christian Højbjerg Lassen[SUP] 4 2 3 [/SUP], Anders Hviid[SUP] 5 [/SUP], Tyra Grove[SUP] 5 [/SUP], Manan Pareek[SUP] 4 2 3 6 [/SUP], Tor Biering-Sørensen[SUP] 4 2 3 6 7 [/SUP]
Affiliations
- PMID: 41022536
- PMCID: PMC12481319
- DOI: 10.1136/openhrt-2025-003584
Background: The long-term effects of myocarditis following COVID-19 vaccination on cardiac function and symptoms remain unclear.
Purpose: To assess the long-term effects of myocarditis following COVID-19 vaccination on cardiac function, inflammatory biomarkers and symptoms.
Methods: Patients with myocarditis within 50 days of receiving COVID-19 vaccination (2021-2022) were invited to follow-up approximately 2 years after initial hospitalisation. Follow-up assessment included echocardiography, biomarkers, ECG, lung ultrasound (LUS) and symptom questionnaires. Patients with myocarditis following COVID-19 vaccination (V-myocarditis) were compared with non-vaccine-related myocarditis (NV-myocarditis) controls admitted during the same period.
Results: 17 patients with V-myocarditis (median age 47 (27-59) years, 53% women) were included. Median time from vaccination to admission was 6 days, with 88% admitted within 30 days. At follow-up (28±6 months), patients with V-myocarditis showed mildly impaired left ventricular (LV) function (median global longitudinal strain (GLS) 16.0% (13.2%-18.2%)) and diastolic dysfunction in 71%. Right ventricular (RV) and LUS findings were preserved. Biomarkers normalised from admission to follow-up with significant reductions in troponin-I (p<0.001) and C-reactive protein (p=0.001), while 35% showed persistent low-grade inflammation. Symptoms were common at follow-up, including fatigue (35%) and chest pain (41%). Compared with NV-myocarditis, patients with V-myocarditis had similar symptoms and biomarker recovery, but lower GLS at follow-up (NV-myocarditis: 18.5% (15.4%-20.3%), p=0.04).
Conclusion: In one of the longest reported follow-up studies of myocarditis following COVID-19 vaccination, patients exhibited mild LV and diastolic dysfunction, preserved RV function and overall normalised biomarkers. A notable proportion continued reporting symptoms, highlighting the need for long-term follow-up.
Keywords: CARDIAC REHABILITATION; Echocardiography; Myocarditis.