@article{Arnold_J-2024_206507,
title = {Myocardial ischaemia following COVID-19: a cardiovascular magnetic resonance study},
author = {Arnold, J. and Yeo, J. and Budgeon, C. and Shergill, S. and England, R. and Shiwani, H. and Artico, J. and Moon, J. and Gorecka, M. and Roditi, G. and Morrow, A. and Mangion, K. and Shanmuganathan, M. and Miller, C. and Chiribiri, A. and Alzahir, M. and Ramirez, S. and Lin, A. and Swoboda, P. and McDiarmid, A. and Sykes, R. and Singh, T. and Bucciarelli-Ducci, C. and Dawson, D. and Fontana, M. and Manisty, C. and Treibel, T. and Levelt, E. and Young, R. and McConnachie, A. and Neubauer, S. and Piechnik, S. and Davies, R. and Ferreira, V. and Dweck, M. and Berry, C. and McCann, G. and Greenwood, J. and Investigators, O. and COVID-HEART Investigators},
month = {dec},
year = {2024},
abstract = {The pathophysiology of myocardial injury following COVID-19 remains uncertain. COVID-HEART was a prospective, multicentre study utilising cardiovascular magnetic resonance (CMR) to characterise COVID-related myocardial injury. In this pre-specified analysis, the objectives were to examine (1) the frequency of myocardial ischaemia following COVID-19, and (2) the association between ischaemia and myocardial injury. We studied 59 patients hospitalised with COVID-19 and elevated serum troponin (COVID + /troponin + , age 61 ± 11 years) and 37 control subjects without COVID-19 or elevated troponin and similar by age and cardiovascular comorbidities (COVID −/comorbidity + , 64 ± 10 years). Subjects underwent multi-parametric CMR (comprising assessment of ventricular volumes, stress perfusion, T1/T2 mapping and scar). The primary endpoint was the frequency of inducible myocardial ischaemia. Inducible ischaemia was evident in 11 (19%) COVID + /troponin + patients and in 8 (22%) control subjects (p= 0.72). In COVID + /troponin + patients with ischaemia, epicardial coronary disease pattern ischaemia was present in eight patients and microvascular disease pattern, in three patients. There was no significant difference in the frequency of inducible ischaemia in COVID + /troponin + patients with previous myocardial infarction and/or revascularisation compared to those without (2/12 [17%] vs. 9/47 [19%] respectively,p= 0.84), or in those with and without scar (7/27 [26%] vs. 4/32 [13%] respectively,p= 0.19). Myocardial ischaemia was present in ~ 20% of patients recently hospitalised with COVID-19 and with elevated cardiac troponin, but this was not different to matched comorbid controls. This finding coupled with the lack of an association between ischaemia and myocardial scar suggests that coronary artery abnormalities are unlikely to be the predominant mechanism underlying COVID-19 induced myocardial injury.},
pages = {247-256},
volume = {41},
journal = {International Journal of Cardiovascular Imaging},
publisher = {Springer Nature},
url = {https://doi.org/10.1007/s10554-024-03304-7},
}
