COVID-19 患者的心血管磁共振成像

Cardiovascular Magnetic Resonance for Patients With COVID-19.

机构信息

William Harvey Research Institute, National Institute for Health Research Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, West Smithfield, London, United Kingdom.

Department of Medicine and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada.

出版信息

JACC Cardiovasc Imaging. 2022 Apr;15(4):685-699. doi: 10.1016/j.jcmg.2021.08.021. Epub 2021 Oct 13.

Abstract

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.

摘要

COVID-19 与由缺血、炎症或心肌炎引起的心肌损伤有关。心血管磁共振(CMR)是心脏功能、结构和组织成分的非侵入性参考标准。CMR 是 COVID-19 患者心肌损伤和心功能障碍证据的有价值的诊断工具。尽管 COVID-19 相关心肌炎可能不常见,但多达 48%的 COVID-19 患者的心血管组织病理学发现与 COVID-19 相关,这引发了对长期心肌损伤的担忧。迄今为止的研究报告称,在从 COVID-19 中康复的住院患者中,有 26%至 60%的患者存在 CMR 异常,包括功能障碍、心肌组织异常、晚期钆增强或心包异常。在 COVID-19 后的运动员中,CMR 检测到心肌炎样异常。在儿童中,多系统炎症综合征可能在感染后 2 至 6 周发生;CMR 可评估相关心肌炎和冠状动脉瘤。目前,我们对 COVID-19 相关心血管受累的了解并不完整,多项研究计划使用 CMR 评估 COVID-19 患者。在这篇综述中,我们总结了 COVID-19 患者 CMR 的现有研究,并介绍了正在进行的研究。我们还为急性症状或从 COVID-19 中康复的患者提供了 CMR 临床应用的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1732/8514168/36f1b7ca6c36/fx1_lrg.jpg

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