Myocardial Strain for the Differentiation of Myocardial Involvement in the Post-Acute Sequelae of COVID-19-A Multiparametric Cardiac MRI Study.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-02-27 DOI:10.3390/tomography10030026

El-Sayed H Ibrahim, Jason Rubenstein, Antonio Sosa, Jadranka Stojanovska, Amy Pan, Paula North, Hallgeir Rui, Ivor Benjamin

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Abstract

Myocardial involvement was shown to be associated with an unfavorable prognosis in patients with COVID-19, which could lead to fatal outcomes as in myocardial injury-induced arrhythmias and sudden cardiac death. We hypothesized that magnetic resonance imaging (MRI) myocardial strain parameters are sensitive markers for identifying subclinical cardiac dysfunction associated with myocardial involvement in the post-acute sequelae of COVID-19 (PASC). This study evaluated 115 subjects, including 65 consecutive COVID-19 patients, using MRI for the assessment of either post-COVID-19 myocarditis or other cardiomyopathies. Subjects were categorized, based on the results of the MRI exams, as having either 'suspected' or 'excluded' myocarditis. A control group of 50 matched individuals was studied. Along with parameters of global cardiac function, the MRI images were analyzed for measurements of the myocardial T1, T2, extracellular volume (ECV), strain, and strain rate. Based on the MRI late gadolinium enhancement and T1/T2/ECV mappings, myocarditis was suspected in 7 out of 22 patients referred due to concern of myocarditis and in 9 out of 43 patients referred due to concern of cardiomyopathies. The myocardial global longitudinal, circumferential, and radial strains and strain rates in the suspected myocarditis group were significantly smaller than those in the excluded myocarditis group, which in turn were significantly smaller than those in the control group. The results showed significant correlations between the strain, strain rate, and global cardiac function parameters. In conclusion, this study emphasizes the value of multiparametric MRI for differentiating patients with myocardial involvement in the PASC based on changes in the myocardial contractility pattern and tissue structure.

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用于区分 COVID-19 急性后遗症心肌受累的心肌应变--多参数心脏磁共振成像研究

研究表明，心肌受累与 COVID-19 患者的不良预后有关，可能导致致命后果，如心肌损伤引起的心律失常和心脏性猝死。我们假设磁共振成像（MRI）心肌应变参数是识别与 COVID-19 急性后遗症（PASC）心肌受累相关的亚临床心功能不全的敏感标记。这项研究对 115 名受试者（包括 65 名连续的 COVID-19 患者）进行了评估，采用核磁共振成像评估 COVID-19 后遗症心肌炎或其他心肌病。根据磁共振成像检查结果，受试者被分为 "疑似 "或 "排除 "心肌炎两类。研究还包括一个由 50 名匹配者组成的对照组。除了整体心脏功能参数外，核磁共振成像图像还用于测量心肌T1、T2、细胞外容积（ECV）、应变和应变率。根据核磁共振成像晚期钆增强和 T1/T2/ECV 映射，在因心肌炎而转诊的 22 名患者中，有 7 人怀疑患有心肌炎；在因心肌病而转诊的 43 名患者中，有 9 人怀疑患有心肌病。疑似心肌炎组的心肌整体纵向、周向和径向应变和应变率明显小于排除心肌炎组，而排除心肌炎组的心肌整体纵向、周向和径向应变和应变率又明显小于对照组。结果显示，应变、应变率和整体心功能参数之间存在明显的相关性。总之，本研究强调了多参数磁共振成像在根据心肌收缩力模式和组织结构的变化区分 PASC 心肌受累患者方面的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.