Cardiac T1 and T2 Mapping Showed Myocardial Involvement in Recovered COVID‐19 Patients Initially Considered Devoid of Cardiac Damage

• Published in: Journal of magnetic resonance imaging Vol. 54; no. 2; pp. 421 - 428
• Main Authors: Pan, Cunxue, Zhang, Zuoquan, Luo, Liyun, Wu, Wenhao, Jia, Taoyu, Lu, Ling, Liu, Weiyin V., Qin, Yujuan, Hu, Feng, Ding, Xianglian, Qin, Peixin, Qian, Long, Chen, Jian, Li, Shaolin
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-08-2021; Wiley Subscription Services, Inc
• Subjects: cardiac involvement; cardiac magnetic resonance imaging; Cardiac output; Cardiovascular diseases; Coronaviruses; COVID-19; Dimers; Field strength; Lymphopenia; Magnetic resonance imaging; Mapping; Markers; Medical imaging; Model testing; Original Research; Population studies; Resonance; Signs and symptoms; Statistical analysis; Statistical tests; Stroke; Stroke volume; Variance analysis; Ventricle; Viral diseases; COVID-19; cardiac involvement; cardiac magnetic resonance imaging
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.27534

Background
Myocardial injury has been found using magnetic resonance imaging in recovered coronavirus disease 2019 (COVID‐19) patients unselected or with ongoing cardiac symptoms.
Purpose
To evaluate for the presence of myocardial involvement in recovered COVID‐19 patients without cardiovascular symptoms and abnormal serologic markers during hospitalization.
Study Type
Prospective.
Population
Twenty‐one recovered COVID‐19 patients and 20 healthy controls (HC).
Field Strength/Sequence
3.0 T, cine, T2‐weighted imaging, T1 mapping, and T2 mapping.
Assessment
Cardiac ventricular function includes end‐diastolic volume, end‐systolic volume, stroke volume, cardiac output, left ventricle (LV) mass, and ejection fraction (EF) of LV and right ventricle (RV), and segmental myocardial T1 and T2 values were measured.
Statistical Tests
Student's t‐test, univariate general linear model test, and chi‐square test were used for analyses between two groups. Ordinary one‐way analyses of variance or Kruskal–Wallis H test were used for analyses between three groups, followed by post‐hoc analyses.
Results
Fifteen (71.43%) COVID‐19 patients had abnormal magnetic resonance findings, including raised myocardial native T1 (5, 23.81%) and T2 values (10, 47.62%), decreased LVEF (1, 4.76%), and RVEF (2, 9.52%). The segmental myocardial T2 value of COVID‐19 patients (49.20 [46.1, 54.6] msec) was significantly higher than HC (48.3 [45.2, 51.7] msec) (P < 0.001), while the myocardial native T1 value showed no significant difference between COVID‐19 patients and HC. The myocardial T2 value of serious COVID‐19 patients (52.5 [48.1, 57.1] msec) was significantly higher than unserious COVID‐19 patients (48.8 [45.9, 53.8] msec) and HC (48.3 [45.2, 51.7]) (P < 0.001). COVID‐19 patients with abnormally elevated D‐dimer, C‐reactive protein, or lymphopenia showed higher myocardial T2 values than without (all P < 0.05).
Data Conclusion
Cardiac involvement was observed in recovered COVID‐19 patients with no preexisting cardiovascular disease, no cardiovascular symptoms, and elevated serologic markers of myocardial injury during the whole course of COVID‐19.
Level of Evidence
1
Technical Efficacy
Stage 5