Background
Post-COVID-19 patients may incur myocardial involvement secondary to systemic inflammation. Our aim was to detect possible oedema/diffuse fibrosis using cardiac magnetic resonance imaging (CMR) mapping and to study myocardial deformation of the left ventricle (LV) using feature tracking (FT).
Methods
Prospective analysis of consecutively recruited post-COVID-19 patients undergoing CMR. T1 and T2 mapping sequences were acquired and FT analysis was performed using 2D steady-state free precession cine sequences. Statistical significance was set to p<0.05.
Results
Included were 57 post-COVID-19 patients and 20 healthy controls, mean age 59±15 years, men 80.7%. The most frequent risk factors were hypertension (33.3%) and dyslipidaemia (36.8%). The contact-to-CMR interval was 81±27 days. LV ejection fraction (LVEF) was 61±10%. Late gadolinium enhancement (LGE) was evident in 26.3% of patients (19.3%, non-ischaemic). T2 mapping values (suggestive of oedema) were higher in the study patients than in the controls (50.9±4.3 ms vs 48±1.9 ms, p<0.01). No between-group differences were observed for native T1 nor for circumferential strain (CS) or radial strain (RS) values (18.6±3.3% vs 19.2±2.1% (p=0.52) and 32.3±8.1% vs 33.6±7.1% (p=0.9), respectively). A sub-group analysis for the contact-to-CMR interval (<8 weeks vs ≥8 weeks) showed that FT-CS (15.6±2.2% vs 18.9±2.6%, p<0.01) and FT-RS (24.9±5.8 vs 33.5±7.2%, p<0.01) values were lower for the shorter interval.
Conclusions
Post-COVID-19 patients compared to heathy controls had raised T2 values (related to oedema), but similar native T1, FT-CS and FT-RS values. FT-CS and FT-RS values were lower in post-COVID-19 patients undergoing CMR after <8 weeks compared to ≥8 weeks.
Three-dimensional transesophageal echocardiography and 4-dimensional flow magnetic resonance imaging as complementary techniques in the preoperative planning of a mitral paravalvular leak allow the evaluation of its location, shape, and size and qualitative-quantitative analysis of mitral regurgitant orifice. (
Level of Difficulty: Intermediate.
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