Journal
JACC-CARDIOVASCULAR IMAGING
Volume 15, Issue 4, Pages 685-699Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcmg.2021.08.021
Keywords
cardiovascular magnetic resonance; COVID-19; ischemia; multisystem inflammatory syndrome; myocardial injury; myocarditis; SARS-CoV-2
Funding
- Bayer AG
- Neosoft
- Medis
- Siemens
- National Institute for Health Research Biomedical Research Centre at Barts
- British Heart Foundation
- British Heart Foundation Centre of Research Excellence, Oxford
- National Institute for Health Research Oxford Biomedical Research Centre at Oxford University Hospitals NHS Foundation Trust
- British Heart Foundation Clinical Research Training Fellowship [FS/17/81/33318]
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COVID-19 is associated with myocardial injury, and cardiovascular magnetic resonance (CMR) is a noninvasive diagnostic tool that can evaluate the cardiac function and tissue abnormalities in patients recovering from COVID-19. Studies have reported CMR abnormalities in up to 60% of recovered COVID-19 patients, including functional impairment, myocardial tissue abnormalities, late gadolinium enhancement, or pericardial abnormalities.
COVID-19 is associated with myocardial injury caused by ischemia, inflammation, or myocarditis. Cardiovascular magnetic resonance (CMR) is the noninvasive reference standard for cardiac function, structure, and tissue composition. CMR is a potentially valuable diagnostic tool in patients with COVID-19 presenting with myocardial injury and evidence of cardiac dysfunction. Although COVID-19-related myocarditis is likely infrequent, COVID-19-related cardiovascular histopathology findings have been reported in up to 48% of patients, raising the concern for long-term myocardial injury. Studies to date report CMR abnormalities in 26% to 60% of hospitalized patients who have recovered from COVID-19, including functional impairment, myocardial tissue abnormalities, late gadolinium enhancement, or pericardial abnormalities. In athletes post-COVID-19, CMR has detected myocarditis-like abnormalities. In children, multisystem inflammatory syndrome may occur 2 to 6 weeks after infection; associated myocarditis and coronary artery aneurysms are evaluable by CMR. At this time, our understanding of COVID-19-related cardiovascular involvement is incomplete, and multiple studies are planned to evaluate patients with COVID-19 using CMR. In this review, we summarize existing studies of CMR for patients with COVID-19 and present ongoing research. We also provide recommendations for clinical use of CMR for patients with acute symptoms or who are recovering from COVID-19. Crown Copyright (C) 2022 Published by Elsevier on behalf of the American College of Cardiology Foundation. All rights reserved.
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