Background: Post-COVID-19 patients may incur myocardial involvement secondary to systemic inflammation. Our aim was to detect possible oedema/diffuse fibrosis using cardiac magnetic resonance imaging (CMR) mapping and to study myocardial deformation of the left ventricle (LV) using feature tracking (FT).
Methods: Prospective analysis of consecutively recruited post-COVID-19 patients undergoing CMR. T1 and T2 mapping sequences were acquired and FT analysis was performed using 2D steady-state free precession cine sequences. Statistical significance was set to p < 0.05.
Results: Included were 57 post-COVID-19 patients and 20 healthy controls, mean age 59 ± 15 years, men 80.7%. The most frequent risk factors were hypertension (33.3%) and dyslipidaemia (36.8%). The contact-to-CMR interval was 81 ± 27 days. LV ejection fraction (LVEF) was 61 ± 10%. Late gadolinium enhancement (LGE) was evident in 26.3% of patients (19.3%, non-ischaemic). T2 mapping values (suggestive of oedema) were higher in the study patients than in the controls (50.9 ± 4.3 ms vs 48 ± 1.9 ms, p < 0.01). No between-group differences were observed for native T1 nor for circumferential strain (CS) or radial strain (RS) values (18.6 ± 3.3% vs 19.2 ± 2.1% (p = 0.52) and 32.3 ± 8.1% vs 33.6 ± 7.1% (p = 0.9), respectively). A sub-group analysis for the contact-to-CMR interval (<8 weeks vs ≥ 8 weeks) showed that FT-CS (15.6 ± 2.2% vs 18.9 ± 2.6%, p < 0.01) and FT-RS (24.9 ± 5.8 vs 33.5 ± 7.2%, p < 0.01) values were lower for the shorter interval.
Conclusions: Post-COVID-19 patients compared to heathy controls had raised T2 values (related to oedema), but similar native T1, FT-CS and FT-RS values. FT-CS and FT-RS values were lower in post-COVID-19 patients undergoing CMR after < 8 weeks compared to ≥ 8 weeks.
Keywords: CMR, Cardiac-magnetic-resonance-imaging; COVID-19; COVID-19, coronavirus disease-2019; CRP, C-reactive-protein; CS, circumferential-strain; Cardiac magnetic resonance imaging; ECG, electrocardiogram; ECV, extracellular-volume; EGE, early-gadolinium-enhancement; FT, feature-tracking; Feature tracking; ICU, intensive-care-unit; IQR, interquartile-range; IR, inversion-recovery; LAX, long-axis-view; LGE, late-gadolinium-enhancement; LS, longitudinal-strain; LV, left-ventricle; LVEDV, LV end-diastolic-volume; LVEF, LV-Ejection-fraction; LVESV, LV-end-systolic-volume; MERS-CoV, Middle-East-respiratory-syndrome-coronavirus; Mapping; PCR, polymerase-chain-reaction; ROI, region-of-interest; RS, radial-strain; RV, right-ventricle; RVEDV, end-diastolic-volume; RVEF, RV-ejection-fraction; RVESV, RV-end-systolic-volume; SARS-CoV-2, severe-acute-respiratory-syndrome-coronavirus-2; SAX, short-axis-view; SCLS, systemic-capillary-leak-syndrome; SD, standard-deviation; SIRS, systemic-inflammatory-response-syndrome; SSFP, steady-state-free-precession; STIR, short-tau-inversion-recovery; TR, repetition-time; TTE, transthoracic-echocardiography.
© 2021 The Author(s).