Post-COVID-19 vaccination myocarditis: a prospective cohort study pre and post vaccination using cardiovascular magnetic resonance.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Magnetic Resonance Pub Date : 2023-12-07 DOI:10.1186/s12968-023-00985-2

Ming-Yen Ng, Cheuk Hang Tam, Yung Pok Lee, Ho Tung Ambrose Fong, Chun-Ka Wong, Wing Kei Carol Ng, Maegan Hon Yan Yeung, Wood-Hay Ian Ling, Sabrina Tsao, Eric Yuk Fai Wan, Vanessa Ferreira, Andrew T Yan, Chung Wah Siu, Kai-Hang Yiu, Ivan Fan-Ngai Hung

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引用次数: 0

Abstract

Background: Concerns about COVID-19 vaccination induced myocarditis or subclinical myocarditis persists in some populations. Cardiac magnetic resonance imaging (CMR) has been used to detect signs of COVID-19 vaccination induced myocarditis. This study aims to: (i) characterise myocardial tissue, function, size before and after COVID-19 vaccination, (ii) determine if there is imaging evidence of subclinical myocardial inflammation or injury after vaccination using CMR.

Methods: Subjects aged ≥ 12yrs old without prior COVID-19 or COVID-19 vaccination underwent two CMR examinations: first, ≤ 14 days before the first COVID-19 vaccination and a second time ≤ 14 days after the second COVID-19 vaccination. Biventricular indices, ejection fraction (EF), global longitudinal strain (GLS), late gadolinium enhancement (LGE), left ventricular (LV) myocardial native T1, T2, extracellular volume (ECV) quantification, lactate dehydrogenase (LDH), white cell count (WCC), C-reactive protein (CRP), NT-proBNP, troponin-T, electrocardiogram (ECG), and 6-min walk test were assessed in a blinded fashion.

Results: 67 subjects were included. First and second CMR examinations were performed a median of 4 days before the first vaccination (interquartile range 1-8 days) and 5 days (interquartile range 3-6 days) after the second vaccination respectively. No significant change in global native T1, T2, ECV, LV EF, right ventricular EF, LV GLS, LGE, ECG, LDH, troponin-T and 6-min walk test was demonstrated after COVID-19 vaccination. There was a significant WCC decrease (6.51 ± 1.49 vs 5.98 ± 1.65, p = 0.003) and CRP increase (0.40 ± 0.22 vs 0.50 ± 0.29, p = 0.004).

Conclusion: This study found no imaging, biochemical or ECG evidence of myocardial injury or inflammation post COVID-19 vaccination, thus providing some reassurance that COVID-19 vaccinations do not typically cause subclinical myocarditis.

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covid -19疫苗接种后心肌炎:使用心血管磁共振进行疫苗接种前后的前瞻性队列研究

背景:在一些人群中，对COVID-19疫苗接种引起的心肌炎或亚临床心肌炎的担忧仍然存在。心脏磁共振成像(CMR)已被用于检测COVID-19疫苗诱导的心肌炎的迹象。本研究旨在:(i)描述COVID-19疫苗接种前后心肌组织、功能、大小的特征，(ii)利用CMR确定疫苗接种后是否有亚临床心肌炎症或损伤的影像学证据。方法:年龄≥12岁，既往未接种COVID-19或未接种COVID-19的受试者进行两次CMR检查，第一次在第一次接种COVID-19前≤14天，第二次在第二次接种COVID-19后≤14天。双室指数、射血分数(EF)、总纵向应变(GLS)、晚期钆增强(LGE)、左室心肌原生T1、T2、细胞外体积(ECV)定量、乳酸脱氢酶(LDH)、白细胞计数(WCC)、c反应蛋白(CRP)、NT-proBNP、肌钙蛋白- t、心电图(ECG)和6分钟步行试验采用盲法评估。结果:纳入67例受试者。第一次和第二次CMR检查分别在第一次疫苗接种前4天(四分位数范围1-8天)和第二次疫苗接种后5天(四分位数范围3-6天)进行。接种COVID-19疫苗后，全球原生T1、T2、ECV、左室EF、右心室EF、左室GLS、LGE、ECG、LDH、肌钙蛋白- t和6分钟步行试验均无显著变化。WCC显著降低(6.51±1.49 vs 5.98±1.65,p = 0.003)， CRP显著升高(0.40±0.22 vs 0.50±0.29,p = 0.004)。结论:本研究未发现COVID-19疫苗接种后心肌损伤或炎症的影像学、生化或心电图证据，从而为COVID-19疫苗接种不会引起亚临床心肌炎提供了一定的保证。

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来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.