Hunain Shiwani BMBS , Jessica Artico MD , James C. Moon MD , Miroslawa Gorecka MB , Gerry P. McCann MD , Giles Roditi MD , Andrew Morrow MBChB , Kenneth Mangion PhD , Elena Lukaschuk MSc , Mayooran Shanmuganathan MBBS , Christopher A. Miller PhD , Amedeo Chiribiri PhD , Mohammed Alzahir MBBS , Sara Ramirez MD , Andrew Lin MBBS , Peter P. Swoboda PhD , Adam K. McDiarmid PhD , Robert Sykes MBChB , Trisha Singh MBBS , Chiara Bucciarelli-Ducci PhD , Ifza Hussain
{"title":"COVID-19 住院患者心肌损伤的临床意义：一项前瞻性、多中心、队列研究。","authors":"Hunain Shiwani BMBS , Jessica Artico MD , James C. Moon MD , Miroslawa Gorecka MB , Gerry P. McCann MD , Giles Roditi MD , Andrew Morrow MBChB , Kenneth Mangion PhD , Elena Lukaschuk MSc , Mayooran Shanmuganathan MBBS , Christopher A. Miller PhD , Amedeo Chiribiri PhD , Mohammed Alzahir MBBS , Sara Ramirez MD , Andrew Lin MBBS , Peter P. Swoboda PhD , Adam K. McDiarmid PhD , Robert Sykes MBChB , Trisha Singh MBBS , Chiara Bucciarelli-Ducci PhD , Ifza Hussain","doi":"10.1016/j.jcmg.2024.06.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.</div></div><div><h3>Methods</h3><div>This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.</div></div><div><h3>Results</h3><div>Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; <em>P <</em> 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; <em>P =</em> 0.50), no change in myocardial scar pattern or volume (<em>P =</em> 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (<em>P <</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; <span><span>ISRCTN58667920</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"17 11","pages":"Pages 1320-1331"},"PeriodicalIF":12.8000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19\",\"authors\":\"Hunain Shiwani BMBS , Jessica Artico MD , James C. Moon MD , Miroslawa Gorecka MB , Gerry P. McCann MD , Giles Roditi MD , Andrew Morrow MBChB , Kenneth Mangion PhD , Elena Lukaschuk MSc , Mayooran Shanmuganathan MBBS , Christopher A. Miller PhD , Amedeo Chiribiri PhD , Mohammed Alzahir MBBS , Sara Ramirez MD , Andrew Lin MBBS , Peter P. Swoboda PhD , Adam K. McDiarmid PhD , Robert Sykes MBChB , Trisha Singh MBBS , Chiara Bucciarelli-Ducci PhD , Ifza Hussain\",\"doi\":\"10.1016/j.jcmg.2024.06.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.</div></div><div><h3>Methods</h3><div>This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.</div></div><div><h3>Results</h3><div>Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; <em>P <</em> 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; <em>P =</em> 0.50), no change in myocardial scar pattern or volume (<em>P =</em> 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (<em>P <</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; <span><span>ISRCTN58667920</span><svg><path></path></svg></span>)</div></div>\",\"PeriodicalId\":14767,\"journal\":{\"name\":\"JACC. Cardiovascular imaging\",\"volume\":\"17 11\",\"pages\":\"Pages 1320-1331\"},\"PeriodicalIF\":12.8000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Cardiovascular imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1936878X24002432\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Cardiovascular imaging","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936878X24002432","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19
Background
Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear.
Objectives
This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes.
Methods
This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months.
Results
Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% ± 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% ± 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001).
Conclusions
Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920)
期刊介绍：
JACC: Cardiovascular Imaging, part of the prestigious Journal of the American College of Cardiology (JACC) family, offers readers a comprehensive perspective on all aspects of cardiovascular imaging. This specialist journal covers original clinical research on both non-invasive and invasive imaging techniques, including echocardiography, CT, CMR, nuclear, optical imaging, and cine-angiography.
JACC. Cardiovascular imaging highlights advances in basic science and molecular imaging that are expected to significantly impact clinical practice in the next decade. This influence encompasses improvements in diagnostic performance, enhanced understanding of the pathogenetic basis of diseases, and advancements in therapy.
In addition to cutting-edge research,the content of JACC: Cardiovascular Imaging emphasizes practical aspects for the practicing cardiologist, including advocacy and practice management.The journal also features state-of-the-art reviews, ensuring a well-rounded and insightful resource for professionals in the field of cardiovascular imaging.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
