PDF(Pubmed)
Abstract：
Myocardial involvement was shown to be associated with an unfavorable prognosis in patients with COVID-19, which could lead to fatal outcomes as in myocardial injury-induced arrhythmias and sudden cardiac death. We hypothesized that magnetic resonance imaging (MRI) myocardial strain parameters are sensitive markers for identifying subclinical cardiac dysfunction associated with myocardial involvement in the post-acute sequelae of COVID-19 (PASC). This study evaluated 115 subjects, including 65 consecutive COVID-19 patients, using MRI for the assessment of either post-COVID-19 myocarditis or other cardiomyopathies. Subjects were categorized, based on the results of the MRI exams, as having either \'suspected\' or \'excluded\' myocarditis. A control group of 50 matched individuals was studied. Along with parameters of global cardiac function, the MRI images were analyzed for measurements of the myocardial T1, T2, extracellular volume (ECV), strain, and strain rate. Based on the MRI late gadolinium enhancement and T1/T2/ECV mappings, myocarditis was suspected in 7 out of 22 patients referred due to concern of myocarditis and in 9 out of 43 patients referred due to concern of cardiomyopathies. The myocardial global longitudinal, circumferential, and radial strains and strain rates in the suspected myocarditis group were significantly smaller than those in the excluded myocarditis group, which in turn were significantly smaller than those in the control group. The results showed significant correlations between the strain, strain rate, and global cardiac function parameters. In conclusion, this study emphasizes the value of multiparametric MRI for differentiating patients with myocardial involvement in the PASC based on changes in the myocardial contractility pattern and tissue structure.
摘要：
心肌受累与COVID-19患者的不良预后相关，这可能导致致命的后果，如心肌损伤引起的心律失常和心源性猝死。我们假设磁共振成像（MRI）心肌应变参数是识别COVID-19（PASC）急性后遗症中与心肌受累相关的亚临床心功能障碍的敏感标志物。这项研究评估了115名受试者，包括65名连续的COVID-19患者，使用MRI评估COVID-19后心肌炎或其他心肌病。受试者被分类，根据核磁共振检查的结果,有“疑似”或“排除”心肌炎。研究了50个匹配个体的对照组。随着整体心功能参数，分析MRI图像以测量心肌T1，T2，细胞外体积（ECV），应变，和应变率。基于MRI晚期钆增强和T1/T2/ECV映射，由于关注心肌炎而转诊的22例患者中有7例被怀疑心肌炎,由于关注心肌病而转诊的43例患者中有9例被怀疑心肌炎.心肌整体纵向，圆周,疑似心肌炎组的径向应变和应变率明显小于排除性心肌炎组，这反过来明显小于对照组。结果表明，菌株之间存在显著的相关性，应变率,和全局心功能参数。总之,这项研究强调了多参数MRI对根据心肌收缩性模式和组织结构的变化区分PASC心肌受累患者的价值.
