Case Report: Transient Increase of CMR T1 Mapping Indices in a Patient With COVID-19 mRNA Vaccine Induced Acute Myocarditis

Ansari, Uzair; Britsch, Simone; Rogowski, Sebastian; Duerschmied, Daniel; Papavassiliu, Theano

doi:10.3389/fcvm.2022.880717

Cited by 7 publications

(6 citation statements)

References 17 publications

(20 reference statements)

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“…However, little is known about long-term follow-up data in patients suffering from mRNA vaccination-associated myocarditis. While in some cases, no pathological CMR patterns (increased T1 time and reduced LVEF) were resolved in the follow-up scan ( 45 ), other patients showed persistent LGE, even though initially abnormal global T1 times normalized and ECV values were decreased ( 18 – 46 ). As CMR shows promising capabilities for risk stratification in myocarditis, those preliminary results encourage future outcome studies, such as larger patient groups ( 47 ).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance imaging patterns of acute COVID-19 mRNA vaccine-associated myocarditis in young male patients: A first single-center experience

Evertz

Schulz

Lange

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe risk of myocarditis after mRNA vaccination against COVID-19 has emerged recently. Current evidence suggests that young male patients are predominantly affected. In the majority of the cases, only mild symptoms were observed. However, little is known about cardiac magnetic resonance (CMR) imaging patterns in mRNA-related myocarditis and their differences when compared to classical viral myocarditis in the acute phase of inflammation.Methods and resultsIn total, 10 mRNA vaccination-associated patients with myocarditis were retrospectively enrolled in this study and compared to 10 patients suffering from viral myocarditis, who were matched for age, sex, comorbidities, and laboratory markers. All patients (n = 20) were hospitalized and underwent a standardized clinical examination, as well as an echocardiography and a CMR. Both, clinical and imaging findings and, in particular, functional and volumetric CMR assessments, as well as detailed tissue characterization using late gadolinium enhancement and T1 + T2-weighted sequences, were compared between both groups. The median age of the overall cohort was 26 years (group 1: 25.5; group 2: 27.5; p = 0.57). All patients described chest pain as the leading reason for their initial presentation. CMR volumetric and functional parameters did not differ significantly between both groups. In all cases, the lateral left ventricular wall showed late gadolinium enhancement without significant differences in terms of the localization or in-depth tissue characterization (late gadolinium enhancement [LGE] enlargement: group 1: 5.4%; group 2: 6.5%; p = 0.14; T2 global/maximum value: group 1: 38.9/52 ms; group 2: 37.8/54.5 ms; p = 0.79 and p = 0.80).ConclusionThis study yielded the first evidence that COVID-19 mRNA vaccine-associated myocarditis does not show specific CMR patterns during the very acute stage in the most affected patient group of young male patients. The observed imaging markers were closely related to regular viral myocarditis in our cohort. Additionally, we could not find any markers implying adverse outcomes in this relatively little number of patients; however, this has to be confirmed by future studies that will include larger sample sizes.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance imaging patterns of acute COVID-19 mRNA vaccine-associated myocarditis in young male patients: A first single-center experience

Evertz

Schulz

Lange

et al. 2022

Front. Cardiovasc. Med.

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“…Following a more detailed evaluation, 381 articles were included for systematic review. Of these, 134 articles (259 cases) reported cardiovascular complications [ 2 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ,…”

Section: Resultsmentioning

confidence: 99%

Cardiac and Neurological Complications Post COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series

Lee,

Yap,

Amin-Nordin

et al. 2024

Vaccines

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Following mass vaccinations for the control of the COVID-19 epidemic, a spectrum of cardiac and neurological disorders was reported among vaccinated individuals. This study examined the range of complications documented and factors related to their occurrence. Three electronic databases were searched for case reports and case series with descriptions of cardiac and/or neurological complications in COVID-19 vaccine recipients. A total of 698 vaccinees were included in this review, of which 259 (37.1%) had cardiac and 439 (62.9%) had neurological complications. Inflammatory conditions were the commonest among the cardiac complications; while polyneuropathy, demyelinating diseases and cerebrovascular disorders were the more common neurological complications. The mean age of those with cardiac complications (33.8 years) was much younger than those with neurological complications (49.7 years). There was no notable difference in the gender distribution between these two groups of vaccine recipients. mRNA vaccines (all brands) were associated with almost 90.0% of the cardiac complications, whereas viral vector vaccines were associated with slightly over half (52.6%) of the neurological complications. With regard to the dose, cardiac complications were more common after the second (69.1%), whereas neurological complications were more common after the first dose (63.6%). The majority of the cases had an uncomplicated clinical course. Nevertheless, 5.9% of cases with neurological complications and 2.5% of those with cardiac complications were fatal, underscoring the significance of the consistent surveillance and vigilant monitoring of vaccinated individuals to mitigate these occurrences.

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“…In a study on 27 patients with cardiac inflammation caused by COVID-19 vaccine, most complained of chest pain, palpitations, joint pain and dyspnea, exhibiting elevated cardiac troponin I (HS cTnI) levels, and 77.8% of patients had ST-segment elevation or T wave inversion in electrocardiogram (ECG) (Table 1a,1b, Ref. [5,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]). Amir et al [20] retrospectively collected 15 cases of myocarditis related to the BNT162b2 mRNA COVID-19 vaccine in five major children's medical centers in Israel.…”

Section: Manifestations Of Myocarditis Caused By Covid-19 Mrna Vaccinementioning

confidence: 99%

“…In contrast, T2 weighted images can highlight the difference in transverse relaxation. When myocardial edema occurs, the tissue shows a strong signal, and T2 time is prolonged [42][43][44][45][46][47]. Giulia et al [48] compared the diagnostic performance of the new and old LLC in different clinical manifestations: myocardial infarction, cardiomyopathy, and arrhythmia.…”

Section: Cmr Evaluation Of Myocarditis Caused By Covid-19 Mrna Vaccinementioning

confidence: 99%

“…In a study on 27 patients with cardiac inflammation caused by COVID-19 vaccine, most complained of chest pain, palpitations, joint pain and dyspnea, exhibiting elevated cardiac troponin I (HS cTnI) levels, and 77.8% of patients had ST-segment elevation or T wave inversion in electrocardiogram (ECG) (Table 1a , 1b , Ref. [ 5 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]). Amir et al .…”

Section: Background: Myocarditis Injury Caused By Covid-19 Mrna Vaccinementioning

confidence: 99%

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CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine

Ba¹,

Chen²,

Shao³

et al. 2022

Rev. Cardiovasc. Med.

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Although immunization with the 2019 coronavirus disease (COVID-19) mRNA vaccine is considered to be an effective measure to reduce the number of serious cases or deaths associated with COVID-19, rare cases of cardiac complications have been reported in the literature, encompassing acute myocardial injury, arrhythmia, vasculitis, endothelial dysfunction, thrombotic myocardial infarction and myocarditis. Interestingly, patients diagnosed with myocarditis after receiving the COVID-19 mRNA vaccine exhibit abnormal cardiac magnetic resonance (CMR) findings, suggesting CMR can be a valuable non-invasive diagnostic tool. In populations immunized with the COVID-19 mRNA vaccine, the risk in teenagers and young men is significantly higher. Myocardial injury in male patients is mainly myocarditis, while in female patients, myocarditis and pericardial effusion are predominantly found. Generally, the symptoms of myocarditis are relatively mild and complete recovery can be achieved. Moreover, the incidence rate associated with the second dose is significantly higher than with the first or third dose. This article brings together the latest evidence on CMR characteristics, influencing factors and pathogenesis of myocarditis caused by the COVID-19 mRNA vaccine. At the same time, we make recommendations for populations requiring immunization with the COVID-19 mRNA vaccine.

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Case Report: Transient Increase of CMR T1 Mapping Indices in a Patient With COVID-19 mRNA Vaccine Induced Acute Myocarditis

Cited by 7 publications

References 17 publications

Cardiovascular magnetic resonance imaging patterns of acute COVID-19 mRNA vaccine-associated myocarditis in young male patients: A first single-center experience

Cardiovascular magnetic resonance imaging patterns of acute COVID-19 mRNA vaccine-associated myocarditis in young male patients: A first single-center experience

Cardiac and Neurological Complications Post COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series

CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine

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