PDF(Pubmed)
Abstract：
Cardiac magnetic resonance (CMR) studies reported CMR abnormalities in patients with mild-moderate SARS-CoV-2 infection, suggesting ongoing myocardial inflammation. Patients (n = 278, 43 ± 13 years, 70.5% female) with post-acute sequelae of SARS-CoV-2 cardiovascular syndrome (PASC-CVS) were included prospectively into the Vienna POSTCOV Registry between March 2021 and March 2023 (clinicaltrials.gov NCT05398952). Clinical, laboratory, and CMR findings were recorded. Patients with abnormal CMR results were classified into isolated chronic pericardial (with/without pleural) effusion, isolated cardiac function impairment, or both (myopericarditis) groups. Medical treatment included a nonsteroidal anti-inflammatory agent (NSAID) for pericardial effusion and a condition-adapted maximal dose of heart failure (HF) treatment. Three months after medical therapy, clinical assessment and CMR were repeated in 82 patients. Laboratory analyses revealed normal hematological, inflammatory, coagulation, and cardiac biomarkers. CMR abnormalities were found in 155 patients (55.8%). Condition-adapted HF treatment led to a significant increase in the left ventricular ejection fraction (LVEF) in patients with initially reduced LVEF (from 49 ± 5% to 56 ± 4%, p = 0.009, n = 25). Low-moderate doses of NSAIDs for 3 months significantly reduced pericardial effusion (from 4/3;5.75/mm to 2/0;3/mm, median/interquartile ranges/p < 0.001, n = 51). Clinical symptoms improved markedly with a decrease in CMR abnormalities, which might be attributed to the maintenance of NSAID and HF medical treatment for PASC-CVS.
摘要：
心脏磁共振（CMR）研究报告了轻度-中度SARS-CoV-2感染患者的CMR异常，提示正在进行的心肌炎症。患者（n=278，43±13岁，70.5％的女性）患有SARS-CoV-2心血管综合征（PASC-CVS）的急性后遗症，在2021年3月至2023年3月之间被前瞻性地纳入了维也纳POSTCOV登记处（clinicaltrials.govNCT05398952）。临床,实验室,并记录CMR结果。将CMR结果异常的患者分为孤立的慢性心包（有/无胸腔）积液，孤立的心脏功能损害，或两者（心肌心包炎）组。药物治疗包括用于心包积液的非甾体抗炎药（NSAID）和适应条件的最大剂量的心力衰竭（HF）治疗。药物治疗三个月后,我们在82例患者中重复进行了临床评估和CMR.实验室分析显示血液学正常,炎症，凝血,和心脏生物标志物。155例（55.8%）患者出现CMR异常。适应条件的HF治疗导致最初LVEF降低的患者左心室射血分数（LVEF）显着增加（从49±5％降至56±4％，p=0.009，n=25）。低-中等剂量的非甾体抗炎药3个月显著减少心包积液（从4/3;5.75/mm到2/0;3/mm，中位数/四分位数间距/p<0.001，n=51）。临床症状明显改善，CMR异常减少，这可能归因于PASC-CVS的NSAID和HF药物治疗的维持。
