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Gulhane A, Soriano B, Stanescu L, Schauer J, Ferguson M, Romberg E, Bhutta S, Otto R, Caris E, Mallenahalli S, Portman M, Litt H, Buddhe S. Objective Comparison of Clinical and Cardiac Magnetic Resonance Biomarkers in Adolescents Presenting With Acute Chest Pain and Elevated Troponins Pre-COVID and Post-COVID Vaccination. J Magn Reson Imaging 2024; 59:1867-1873. [PMID: 37622988 DOI: 10.1002/jmri.28971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Affiliation(s)
- Avanti Gulhane
- Department of Cardiothoracic Radiology, University of Washington, Seattle, Washington, USA
| | - Brian Soriano
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Luana Stanescu
- Department of Pediatric Radiology, University of Washington, Seattle, Washington, USA
| | - Jenna Schauer
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Mark Ferguson
- Department of Pediatric Radiology, University of Washington, Seattle, Washington, USA
| | - Erin Romberg
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Sadaf Bhutta
- Department of Pediatric Radiology, University of Washington, Seattle, Washington, USA
| | - Randolph Otto
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Elizabeth Caris
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Sathish Mallenahalli
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Michael Portman
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Harold Litt
- Department of Radiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sujatha Buddhe
- Department of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
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Ba CF, Chen BH, Shao LS, Zhang Y, Shi C, Wu LM, Xu JR. CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine. Rev Cardiovasc Med 2022; 23:339. [PMID: 39077131 PMCID: PMC11267357 DOI: 10.31083/j.rcm2310339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/13/2022] [Accepted: 08/26/2022] [Indexed: 07/31/2024] Open
Abstract
Although immunization with the 2019 coronavirus disease (COVID-19) mRNA vaccine is considered to be an effective measure to reduce the number of serious cases or deaths associated with COVID-19, rare cases of cardiac complications have been reported in the literature, encompassing acute myocardial injury, arrhythmia, vasculitis, endothelial dysfunction, thrombotic myocardial infarction and myocarditis. Interestingly, patients diagnosed with myocarditis after receiving the COVID-19 mRNA vaccine exhibit abnormal cardiac magnetic resonance (CMR) findings, suggesting CMR can be a valuable non-invasive diagnostic tool. In populations immunized with the COVID-19 mRNA vaccine, the risk in teenagers and young men is significantly higher. Myocardial injury in male patients is mainly myocarditis, while in female patients, myocarditis and pericardial effusion are predominantly found. Generally, the symptoms of myocarditis are relatively mild and complete recovery can be achieved. Moreover, the incidence rate associated with the second dose is significantly higher than with the first or third dose. This article brings together the latest evidence on CMR characteristics, influencing factors and pathogenesis of myocarditis caused by the COVID-19 mRNA vaccine. At the same time, we make recommendations for populations requiring immunization with the COVID-19 mRNA vaccine.
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Affiliation(s)
- Chao-Fei Ba
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Bing-Hua Chen
- Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, 200127 Shanghai, China
| | - Li-Shi Shao
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Ya Zhang
- Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Xishan District, 650118 Kunming, Yunnan, China
| | - Chen Shi
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, 650500 Kunming, Yunnan, China
| | - Lian-Ming Wu
- Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, 200127 Shanghai, China
| | - Jian-Rong Xu
- Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, 200127 Shanghai, China
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Evertz R, Schulz A, Lange T, Backhaus SJ, Vollmann D, Kowallick JT, von Haehling S, Hasenfuß G, Schuster A. Cardiovascular magnetic resonance imaging patterns of acute COVID-19 mRNA vaccine-associated myocarditis in young male patients: A first single-center experience. Front Cardiovasc Med 2022; 9:965512. [PMID: 36082124 PMCID: PMC9445185 DOI: 10.3389/fcvm.2022.965512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/25/2022] [Indexed: 01/14/2023] Open
Abstract
Background The risk of myocarditis after mRNA vaccination against COVID-19 has emerged recently. Current evidence suggests that young male patients are predominantly affected. In the majority of the cases, only mild symptoms were observed. However, little is known about cardiac magnetic resonance (CMR) imaging patterns in mRNA-related myocarditis and their differences when compared to classical viral myocarditis in the acute phase of inflammation. Methods and results In total, 10 mRNA vaccination-associated patients with myocarditis were retrospectively enrolled in this study and compared to 10 patients suffering from viral myocarditis, who were matched for age, sex, comorbidities, and laboratory markers. All patients (n = 20) were hospitalized and underwent a standardized clinical examination, as well as an echocardiography and a CMR. Both, clinical and imaging findings and, in particular, functional and volumetric CMR assessments, as well as detailed tissue characterization using late gadolinium enhancement and T1 + T2-weighted sequences, were compared between both groups. The median age of the overall cohort was 26 years (group 1: 25.5; group 2: 27.5; p = 0.57). All patients described chest pain as the leading reason for their initial presentation. CMR volumetric and functional parameters did not differ significantly between both groups. In all cases, the lateral left ventricular wall showed late gadolinium enhancement without significant differences in terms of the localization or in-depth tissue characterization (late gadolinium enhancement [LGE] enlargement: group 1: 5.4%; group 2: 6.5%; p = 0.14; T2 global/maximum value: group 1: 38.9/52 ms; group 2: 37.8/54.5 ms; p = 0.79 and p = 0.80). Conclusion This study yielded the first evidence that COVID-19 mRNA vaccine-associated myocarditis does not show specific CMR patterns during the very acute stage in the most affected patient group of young male patients. The observed imaging markers were closely related to regular viral myocarditis in our cohort. Additionally, we could not find any markers implying adverse outcomes in this relatively little number of patients; however, this has to be confirmed by future studies that will include larger sample sizes.
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Affiliation(s)
- Ruben Evertz
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Alexander Schulz
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Torben Lange
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Sören J. Backhaus
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Dirk Vollmann
- Herz- and Gefäßzentrum Göttingen, Göttingen, Germany
| | - Johannes T. Kowallick
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Göttingen, Germany
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