Myocardial Injury by COVID-19 Infection Assessed by Cardiovascular Magnetic Resonance Imaging　― A Prospective Multicenter Study ―

Shingo Kato; Takeshi Kitai; Daisuke Utsunomiya; Mai Azuma; Kazuki Fukui; Eri Hagiwara; Takashi Ogura; Yuki Ishibashi; Taiji Okada; Hiroki Kitakata; Yasuyuki Shiraishi; Shunsuke Torii; Koichi Ohashi; Kazufumi Takamatsu; Akihito Yokoyama; Ken-Ichi Hirata; Yuya Matsue; Koichi Node

doi:10.1253/circj.CJ-23-0729

Shingo Kato, Takeshi Kitai, Daisuke Utsunomiya, Mai Azuma, Kazuki Fukui, Eri Hagiwara, Takashi Ogura, Yuki Ishibashi, Taiji Okada, Hiroki Kitakata, Yasuyuki Shiraishi, Shunsuke Torii, Koichi Ohashi, Kazufumi Takamatsu, Akihito Yokoyama, Ken-Ichi Hirata, Yuya Matsue , Koichi Node

Author information

Shingo Kato
Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine [Japan]
Takeshi Kitai
Department of Cardiology, National Cerebral and Cardiovascular Center [Japan]
Daisuke Utsunomiya
Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine [Japan]
Mai Azuma
Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center [Japan]
Kazuki Fukui
Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center [Japan]
Eri Hagiwara
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center [Japan]
Takashi Ogura
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center [Japan]
Yuki Ishibashi
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine [Japan]
Taiji Okada
Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital [Japan]
Hiroki Kitakata
Department of Cardiology, Keio University School of Medicine [Japan]
Yasuyuki Shiraishi
Department of Cardiology, Keio University School of Medicine [Japan]
Shunsuke Torii
Department of Cardiology, National Center for Global Health and Medicine [Japan]
Koichi Ohashi
Department of Cardiology, Tokyo Metropolitan Bokutoh Hospital [Japan]
Kazufumi Takamatsu
Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University [Japan]
Akihito Yokoyama
Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University [Japan]
Ken-Ichi Hirata
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine [Japan]
Yuya Matsue Corresponding author
Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine [Japan]
Koichi Node
Department of Cardiovascular Medicine, Saga University [Japan]

Keywords: Cardiac magnetic resonance imaging, COVID-19, Myocardial injury, Myocarditis

JOURNAL OPEN ACCESS FULL-TEXT HTML Advance online publication
Supplementary material

Article ID: CJ-23-0729

DOI https://doi.org/10.1253/circj.CJ-23-0729

Details

Abstract

Background: This prospective multicenter study assessed the prevalence of myocardial injury in patients with COVID-19 using cardiac magnetic resonance imaging (CMR).

Methods and Results: We prospectively screened 505 patients with moderate to severe COVID-19 disease from 7 hospitals in Japan. Of these patients, 31 (mean [±SD] age 63.5±10.4 years, 23 [74%] male) suspected of myocardial injury, based on elevated serum troponin or B-type natriuretic peptide concentrations either upon admission or 3 months after discharge, underwent CMR 3 months after discharge. The primary endpoint was the presence of myocardial injury, defined by any of the following: (1) contrast enhancement in the left or right ventricle myocardium on late gadolinium enhancement CMR; (2) left or right ventricular dysfunction (defined as <50% and <45%, respectively); and (3) pericardial thickening on contrast enhancement. The mean (±SD) duration between diagnosis and CMR was 117±16 days. The primary endpoint was observed in 13 of 31 individuals (42%), with 8 (26%) satisfying the modified Lake Louise Criteria for the diagnosis of acute myocarditis.

Conclusions: This study revealed a high incidence of myocardial injury identified by CMR in patients with moderate to severe COVID-19 and abnormal findings for cardiac biomarkers.

Corresponding author

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