UNASSIGNED: We performed a systematic search in online databases using relevant key terms covering COVID-19 vaccine, myocarditis, follow-up, and cardiac MRI. We included all observational studies that reported cardiac MRI findings of patients with myocarditis following COVID-19 vaccination in both acute and follow-up phases. Data on clinical outcomes and cardiac MRI findings were extracted and pooled using a random-effect model.
UNASSIGNED: A total of 27 studies (126 patients) met our eligibility criteria. At the time of follow-up, myocarditis symptoms were resolved in all patients, but abnormal electrocardiography and elevated troponin levels were detected in 18.7% and 3.8% of them, respectively. Median imaging follow-up times varied from 3 to 6.3 months. On follow-up cardiac MRI, the persistence of LGE was observed in 76% (95%CI: 62 to 85%), but its extension declined compared to the baseline in almost all patients. Persistent LGE was accompanied by myocardial edoema in six patients, and it was consistent with myocardial fibrosis (LGE without edoema) in the remaining cases. Mean changes (95%CI) of cardiac MRI left ventricular ejection fraction (LVEF) (%) was +2.97 (+1.59 to +4.34) from baseline.
UNASSIGNED: In conclusion, although most patients likely experience favourable clinical outcomes without serious complications, cardiac MRI abnormalities, mainly LGE, may persist in a notable proportion of them beyond the acute phase.
我们使用涵盖COVID-19疫苗的相关关键术语在在线数据库中进行了系统搜索,心肌炎,后续行动,心脏MRI。我们纳入了所有观察性研究,这些研究报告了在急性和随访阶段接种COVID-19疫苗后心肌炎患者的心脏MRI表现。使用随机效应模型提取并汇集临床结果和心脏MRI结果的数据。
■共有27项研究(126名患者)符合我们的资格标准。在后续行动时,所有患者的心肌炎症状均得到缓解,但其中18.7%和3.8%的患者心电图异常和肌钙蛋白水平升高,分别。中位影像学随访时间为3至6.3个月。在心脏MRI随访中,LGE的持久性在76%(95CI:62至85%)中观察到,但与基线相比,在几乎所有患者中,其延伸幅度均下降.6例患者持续性LGE伴有心肌水肿,其余病例与心肌纤维化(LGE无水肿)一致。心脏MRI左心室射血分数(LVEF)(%)的平均变化(95CI)为+2.97(+1.59至+4.34)。
■总而言之,尽管大多数患者可能在没有严重并发症的情况下获得良好的临床结局,心脏MRI异常,主要是LGE,可能会在急性期之后持续存在其中的显着比例。