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COVID-19 vaccine-associated myocarditis milder, confirms Cardiac MRI based study

MedhaBy MedhaPublished On 2022-02-26T09:00:04+05:30  |  Updated On 2022-02-26T09:00:32+05:30
COVID-19 vaccine-associated myocarditis milder, confirms Cardiac MRI based study

Canada: Cardiac MRI shows the presence of a similar pattern of myocardial injury in myocarditis associated with the COVID-19 vaccine compared to myocarditis caused by other factors, says a recent study in the journal Radiology. Abnormalities although were found to be less severe, with no adverse events, and less frequent septal involvement over short-term follow-up. Myocarditis is...

Canada: Cardiac MRI shows the presence of a similar pattern of myocardial injury in myocarditis associated with the COVID-19 vaccine compared to myocarditis caused by other factors, says a recent study in the journal Radiology. Abnormalities although were found to be less severe, with no adverse events, and less frequent septal involvement over short-term follow-up. 

Myocarditis is a non-ischemic inflammatory disease of the heart muscle (myocardium), with diverse causes, clinical patterns, and outcomes. Myocarditis after immunization is a rare occurrence that recently has received increased attention recently due to reports of myocardial injury in a minority of patients who received messenger RNA (mRNA) based COVID-19 vaccines. However, there is not much data on the pattern and severity of myocardial injury in patients with COVID-19 vaccination-associated myocarditis.

Against the above background, Matteo Fronza, Department of Medical Imaging, Women's College Hospital, University of Toronto, Toronto, and colleagues aimed to describe myocardial injury following COVID-19 vaccination compared these findings to other causes of myocarditis in a retrospective cohort study. 

The study included consecutive adult patients with myocarditis with at least one T1-based and at least one T2-based abnormality on cardiac MRI performed at a tertiary referral hospital between 2019-2021. Patients were categorized into three groups: myocarditis following COVID-19 vaccination, myocarditis following COVID-19 illness, and other myocarditis not associated with COVID-19 vaccination or illness. 

The study yielded the following findings:

· Of the 92 included patients, 21 (22%) had myocarditis following COVID-19 vaccination (mean age 31 years ±14; 17 men; mRNA-1273 in 12 [57%] and BNT162b2 in 9 [43%]).

· Ten patients (11%) had myocarditis following COVID-19 illness (mean age 51 years ±14; 3 men), and 61 (66%) had other myocarditis (mean age 44 years ±18; 36 men).

· MRI findings in vaccine-associated myocarditis included late gadolinium enhancement (LGE) in 17 (81%) and left ventricular dysfunction in 6 (29%).

· Compared with other causes of myocarditis, patients with vaccine-associated myocarditis had higher left ventricular ejection fraction and less extensive LGE, even after controlling for age, sex, and duration between symptom onset and MRI.

· The most frequent location of LGE in all groups was subepicardial at the basal inferolateral wall, although septal involvement was less common in vaccine-associated myocarditis.

· At short-term follow-up (median 22 days), all patients with vaccine-associated myocarditis were asymptomatic with no adverse events.

To conclude, the study demonstrates that the pattern of MRI abnormalities in vaccine-associated myocarditis is similar to other causes although patient demographics differ and MRI findings tend to be less severe. 

Reference:

The study titled, Myocardial Injury Pattern at MRI in COVID-19 Vaccine–associated Myocarditis," was published in the journal Radiology. 

DOI: https://doi.org/10.1148/radiol.212559

Radiology journal COVID-19 myocarditis cardiac MRI 
Source : Radiology journal
Medha
Medha

    Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751

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