Sewanan Lorenzo R, Di Tullio Marco R, Laine Andrew F, D'Souza Belinda, Leb Jay, Mironov Alexander, Khan Ahsan, Stanger Dylan E, Konofagou Elisa E, Goldsmith Rochelle L, Jambawalikar Sachin R, Hirschfeld Cole B, Castillo Michelle, Durkin Kathleen J, Dashnaw Stephen, Thomas Vaughan J, Einstein Andrew J
Department of Medicine, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203E, New York 10032, NY, USA.
Seymour, Paul, and Gloria Milstein Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, 622 West 168th Street, PH 10-203E, New York 10032, NY, USA.
Eur Heart J Imaging Methods Pract. 2023 Oct 26;1(2):qyad034. doi: 10.1093/ehjimp/qyad034. eCollection 2023 Sep.
Many patients with coronavirus disease-2019 (COVID-19), particularly from the pandemic's early phase, have been reported to have evidence of cardiac injury such as cardiac symptoms, troponinaemia, or imaging or ECG abnormalities during their acute course. Cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE) have been widely used to assess cardiac function and structure and characterize myocardial tissue during COVID-19 with report of numerous abnormalities. Overall, findings have varied, and long-term impact of COVID-19 on the heart needs further elucidation.
We performed TTE and 3 T CMR in survivors of the initial stage of the pandemic without pre-existing cardiac disease and matched controls at long-term follow-up a median of 308 days after initial infection. Study population consisted of 40 COVID-19 survivors (50% female, 28% Black, and 48% Hispanic) and 12 controls of similar age, sex, and race-ethnicity distribution; 35% had been hospitalized with 28% intubated. We found no difference in echocardiographic characteristics including measures of left and right ventricular structure and systolic function, valvular abnormalities, or diastolic function. Using CMR, we also found no differences in measures of left and right ventricular structure and function and additionally found no significant differences in parameters of tissue structure including T1, T2, extracellular volume mapping, and late gadolinium enhancement. With analysis stratified by patient hospitalization status as an indicator of COVID-19 severity, no differences were uncovered.
Multimodal imaging of a diverse cohort of COVID-19 survivors indicated no long-lasting damage or inflammation of the myocardium.
据报道，许多2019冠状病毒病（COVID-19）患者，尤其是疫情早期阶段的患者，在急性期有心脏损伤的证据，如心脏症状、肌钙蛋白血症，或影像学或心电图异常。心脏磁共振成像（CMR）和经胸超声心动图（TTE）已被广泛用于评估COVID-19期间的心脏功能和结构，并对心肌组织进行特征描述，有大量异常报告。总体而言，研究结果各不相同，COVID-19对心脏的长期影响需要进一步阐明。
我们对疫情初期无基础心脏病的幸存者进行了TTE和3T CMR检查，并在初次感染后中位308天的长期随访中设置了匹配的对照组。研究人群包括40名COVID-19幸存者（50%为女性，28%为黑人，48%为西班牙裔）和12名年龄、性别和种族-民族分布相似的对照组；35%的患者曾住院治疗，其中28%曾插管。我们发现超声心动图特征没有差异，包括左右心室结构和收缩功能的测量、瓣膜异常或舒张功能。使用CMR，我们还发现左右心室结构和功能的测量没有差异，此外，在组织结构参数（包括T1、T2、细胞外容积映射和延迟钆增强）方面也没有显著差异。以患者住院状态作为COVID-19严重程度的指标进行分层分析，未发现差异。
对不同队列的COVID-19幸存者进行多模态成像显示，心肌没有长期损伤或炎症。
