Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease

Atul Kapoor; Aprajita Kapur

doi:doi:10.11648/j.ccr.20220604.14

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Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease

Atul Kapoor, Aprajita Kapur

Published in Cardiology and Cardiovascular Research (Volume 6, Issue 4)

Received: 10 November 2022 Accepted: 28 November 2022 Published: 8 December 2022

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Abstract

Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.

Published in	Cardiology and Cardiovascular Research (Volume 6, Issue 4)
DOI	10.11648/j.ccr.20220604.14
Page(s)	109-117
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

COVID-19, Myocarditis, Cardiac MRI

References

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APA Style

Atul Kapoor, Aprajita Kapur. (2022). Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiology and Cardiovascular Research, 6(4), 109-117. https://doi.org/10.11648/j.ccr.20220604.14

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ACS Style

Atul Kapoor; Aprajita Kapur. Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiol. Cardiovasc. Res. 2022, 6(4), 109-117. doi: 10.11648/j.ccr.20220604.14

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AMA Style

Atul Kapoor, Aprajita Kapur. Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiol Cardiovasc Res. 2022;6(4):109-117. doi: 10.11648/j.ccr.20220604.14

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@article{10.11648/j.ccr.20220604.14,
  author = {Atul Kapoor and Aprajita Kapur},
  title = {Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease},
  journal = {Cardiology and Cardiovascular Research},
  volume = {6},
  number = {4},
  pages = {109-117},
  doi = {10.11648/j.ccr.20220604.14},
  url = {https://doi.org/10.11648/j.ccr.20220604.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220604.14},
  abstract = {Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.},
 year = {2022}
}

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TY  - JOUR
T1  - Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease
AU  - Atul Kapoor
AU  - Aprajita Kapur
Y1  - 2022/12/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ccr.20220604.14
DO  - 10.11648/j.ccr.20220604.14
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 109
EP  - 117
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20220604.14
AB  - Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.
VL  - 6
IS  - 4
ER  -

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Author Information

Atul Kapoor

Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, India
Aprajita Kapur

Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, India

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APA Style

Atul Kapoor, Aprajita Kapur. (2022). Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiology and Cardiovascular Research, 6(4), 109-117. https://doi.org/10.11648/j.ccr.20220604.14

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ACS Style

Atul Kapoor; Aprajita Kapur. Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiol. Cardiovasc. Res. 2022, 6(4), 109-117. doi: 10.11648/j.ccr.20220604.14

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AMA Style

Atul Kapoor, Aprajita Kapur. Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease. Cardiol Cardiovasc Res. 2022;6(4):109-117. doi: 10.11648/j.ccr.20220604.14

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@article{10.11648/j.ccr.20220604.14,
  author = {Atul Kapoor and Aprajita Kapur},
  title = {Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease},
  journal = {Cardiology and Cardiovascular Research},
  volume = {6},
  number = {4},
  pages = {109-117},
  doi = {10.11648/j.ccr.20220604.14},
  url = {https://doi.org/10.11648/j.ccr.20220604.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220604.14},
  abstract = {Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease
AU  - Atul Kapoor
AU  - Aprajita Kapur
Y1  - 2022/12/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ccr.20220604.14
DO  - 10.11648/j.ccr.20220604.14
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 109
EP  - 117
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20220604.14
AB  - Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.
VL  - 6
IS  - 4
ER  -

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