Biomaterial Database

Natural History of Myocardial Injury After COVID-19 Vaccine-Associated Myocarditis. 2022

Muhammad Mustafa Alhussein, and Mohamad Rabbani, and Bradley Sarak, and Steven Dykstra, and Dina Labib, and Jacqueline Flewitt, and Carmen P Lydell, and Andrew G Howarth, and Neil Filipchuck, and Angela Kealey, and Jillian Colbert, and Nita Guron, and Louis Kolman, and Naeem Merchant, and Murad Bandali, and Mike Bristow, and James A White

Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.

Acute myocarditis is a rare complication of mRNA-based COVID-19 vaccination. Little is known about the natural history of this complication. Baseline and convalescent (≥ 90 days) cardiac magnetic resonance (CMR) imaging assessments were performed in 20 consecutive patients meeting Updated Lake Louise Criteria for acute myocarditis within 10 days of mRNA-based vaccination. CMR-based changes in left ventricular volumes, mass, ejection fraction (LVEF), markers of tissue inflammation (native T1 and T2 mapping), and fibrosis (late gadolinium enhancement [LGE] and extracellular volume [ECV]) were assessed between baseline and convalescence. Cardiac symptoms and clinical outcomes were captured. Median age was 23.1 years (range 18-39 years), and 17 (85%) were male. Convalescent evaluations were performed at a median (IQR) 3.7 (3.3-6.2) months. The LVEF showed a mean 3% absolute improvement, accompanied by a 7% reduction in LV end-diastolic volume and 5% reduction in LV mass (all P < 0.015). Global LGE burden was reduced by 66% (P < 0.001). Absolute reductions in global T2, native T1, and ECV of 2.1 ms, 58 ms, and 2.9%, repectively, were documented (all P ≤ 0.001). Of 5 patients demonstrating LVEF ≤ 50% at baseline, all recovered to above this threshold in convalescence. A total of 18 (90%) patients showed persistence of abnormal LGE although mean fibrosis burden was < 5% of LV mass in 85% of cases. No patient experienced major clinical outcomes. COVID-19 mRNA vaccine-associated myocarditis showed rapid improvements in CMR-based markers of edema, contractile function, and global LGE burden beyond 3 months of recovery in this young patient cohort. However, regional fibrosis following edema resolution was commonly observed, justifying need for ongoing surveillance.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D009205	Myocarditis	Inflammatory processes of the muscular walls of the heart (MYOCARDIUM) which result in injury to the cardiac muscle cells (MYOCYTES, CARDIAC). Manifestations range from subclinical to sudden death (DEATH, SUDDEN). Myocarditis in association with cardiac dysfunction is classified as inflammatory CARDIOMYOPATHY usually caused by INFECTION, autoimmune diseases, or responses to toxic substances. Myocarditis is also a common cause of DILATED CARDIOMYOPATHY and other cardiomyopathies.	Carditis,Myocarditides
D009206	Myocardium	The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.	Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D011237	Predictive Value of Tests	In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.	Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D003287	Contrast Media	Substances used to allow enhanced visualization of tissues.	Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D003289	Convalescence	The period of recovery following an illness.	Convalescences
D005260	Female		Females
D005355	Fibrosis	Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.	Cirrhosis,Fibroses
D005682	Gadolinium	An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors.
D006335	Heart Injuries	General or unspecified injuries to the heart.	Cardiac Rupture, Traumatic,Heart Rupture, Traumatic,Injuries, Heart,Cardiac Ruptures, Traumatic,Heart Injury,Heart Ruptures, Traumatic,Injury, Heart,Rupture, Traumatic Cardiac,Rupture, Traumatic Heart,Ruptures, Traumatic Cardiac,Ruptures, Traumatic Heart,Traumatic Cardiac Rupture,Traumatic Cardiac Ruptures,Traumatic Heart Rupture,Traumatic Heart Ruptures