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Cardiac MRI Findings of Myocarditis After COVID-19 mRNA Vaccination in Adolescents.

作者信息

Chelala Lydia, Jeudy Jean, Hossain Rydhwana, Rosenthal Geoffrey, Pietris Nicholas, White Charles S

机构信息

Department of Diagnostic Radiology, University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637.

Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD 21201.

出版信息

AJR Am J Roentgenol. 2022 Apr;218(4):651-657. doi: 10.2214/AJR.21.26853. Epub 2021 Oct 27.


DOI:10.2214/AJR.21.26853
PMID:34704459
Abstract

A possible association has been reported between COVID-19 messenger RNA (mRNA) vaccination and myocarditis. The purpose of our study was to describe cardiac MRI findings in patients with myocarditis after COVID-19 mRNA vaccination. This retrospective study included patients without known prior SARS-CoV-2 infection who underwent cardiac MRI between May 14, 2021, and June 14, 2021, for suspected myocarditis within 2 weeks of COVID-19 mRNA vaccination. Information regarding clinical presentation, hospital course, and events after hospital discharge were recorded. A cardiothoracic imaging fellow and cardiothoracic radiologist reviewed cardiac MRI examinations in consensus. Data were summarized descriptively. Of 52 patients without known prior SARS-CoV-2 infection who underwent cardiac MRI during the study period, five underwent MRI for suspected myocarditis after recent COVID-19 mRNA vaccination. All five patients were male patients ranging in age from 16 to 19 years (mean, 17.2 ± 1.0 [SD] years) who presented within 4 days of receiving the second dose of a COVID-19 mRNA vaccine. Troponin levels were elevated in all patients (mean peak troponin I value, 6.82 ± 4.13 ng/mL). Alternate possible causes of myocarditis were deemed clinically unlikely on the basis of medical history, physical examination findings, myocarditis viral panel, and toxicology screening. Cardiac MRI findings were consistent with myocarditis in all five patients on the basis of the Lake Louise criteria, including early gadolinium enhancement and late gadolinium enhancement (LGE) in all patients and corresponding myocardial edema in four patients. All five patients had a favorable hospital course and were discharged from the hospital in stable condition with improved or resolved symptoms after hospitalization (mean length of hospital stay, 4.8 days). Two patients underwent repeat cardiac MRI that showed persistent, although decreased, LGE. Three patients reported mild intermittent self-resolving chest pain after hospital discharge, and two patients had no recurrent symptoms after discharge. In this small case series, all patients with myocarditis after COVID-19 vaccination were male adolescents and had a favorable initial clinical course. All patients showed cardiac MRI findings typical of myocarditis from other causes. LGE persisted in two patients who underwent repeat MRI. These observations do not establish causality. Radiologists should be aware of a possible association of COVID-19 mRNA vaccination and myocarditis and recognize the role of cardiac MRI in the assessment of suspected myocarditis after COVID-19 vaccination.

摘要

相似文献

[1]
Cardiac MRI Findings of Myocarditis After COVID-19 mRNA Vaccination in Adolescents.

AJR Am J Roentgenol. 2022-4

[2]
Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination.

Circulation. 2022-2

[3]
Cardiovascular magnetic resonance imaging and clinical follow-up in patients with clinically suspected myocarditis after COVID-19 vaccination.

J Cardiovasc Magn Reson. 2024

[4]
Follow-up cardiac magnetic resonance in children with vaccine-associated myocarditis.

Eur J Pediatr. 2022-7

[5]
Cardiac MRI in Suspected Acute Myocarditis After COVID-19 mRNA Vaccination.

Rofo. 2022-9

[6]
Short-term outcome of late gadolinium changes detected on cardiovascular magnetic resonance imaging following coronavirus disease 2019 Pfizer/BioNTech vaccine-related myocarditis in adolescents.

Pediatr Radiol. 2023-5

[7]
Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military.

JAMA Cardiol. 2021-10-1

[8]
Myopericarditis after messenger RNA Coronavirus Disease 2019 Vaccination in Adolescents 12 to 18 Years of Age.

J Pediatr. 2021-11

[9]
Association of Myocarditis With BNT162b2 Messenger RNA COVID-19 Vaccine in a Case Series of Children.

JAMA Cardiol. 2021-12-1

[10]
Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination.

JAMA Cardiol. 2021-10-1

引用本文的文献

[1]
CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.

Rev Cardiovasc Med. 2022-10-11

[2]
Cardiac and Neurological Complications Post COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series.

Vaccines (Basel). 2024-5-24

[3]
MRI of cardiac involvement in COVID-19.

Br J Radiol. 2024-8-1

[4]
Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department.

Diagnostics (Basel). 2024-3-1

[5]
A Study on the Self-Reported Physician-Diagnosed Cardiac Complications Post mRNA Vaccination in Saudi Arabia.

Cureus. 2024-1-11

[6]
Vaccination-Associated Myocarditis and Myocardial Injury.

Circ Res. 2023-5-12

[7]
Cardiac MRI with late gadolinium enhancement shows cardiac involvement 3-6 months after severe acute COVID-19 similar to or worse than PIMS.

Front Cardiovasc Med. 2023-1-25

[8]
Vaccine-associated myocarditis: a case report and summary of the literature.

World J Emerg Med. 2022

[9]
COVID-19 Vaccination-Associated Myocarditis: A Literature Review.

Cureus. 2022-11-29

[10]
Intricacies Affiliated With Post-COVID Vaccine Complications in Makkah Province, Saudi Arabia.

Cureus. 2022-12-20

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