AI Article Synopsis
- * Study Design: Researchers conducted a retrospective cohort study involving children diagnosed with C-VAM between May and December 2021, and compared them to classic myocarditis cases from January 2015 to December 2021, focusing on CMR results.
- * Results: C-VAM patients exhibited less left ventricular dysfunction and a lower frequency of late gadolinium enhancement (LGE) compared to classic myocarditis, indicating less severe cardiac involvement; by the intermediate follow-up, most C-VAM patients showed normal
Article Abstract
Objective: To report intermediate cardiac magnetic resonance (CMR) findings of coronavirus disease 2019 (COVID-19) vaccine-associated myopericarditis (C-VAM) and compare with classic myocarditis.
Study Design: Retrospective cohort study including children diagnosed with C-VAM from May 2021 through December 2021 with early and intermediate CMR. Patients with classic myocarditis from January 2015 through December 2021 and intermediate CMR were included for comparison.
Results: There were 8 patients with C-VAM and 20 with classic myocarditis. Among those with C-VAM, CMR performed at a median 3 days (IQR 3, 7) revealed 2 of 8 patients with left ventricular ejection fraction <55%, 7 of 7 patients receiving contrast with late gadolinium enhancement (LGE), and 5 of 8 patients with elevated native T1 values. Borderline T2 values suggestive of myocardial edema were present in 6 of 8 patients. Follow-up CMRs performed at a median 107 days (IQR 97, 177) showed normal ventricular systolic function, T1, and T2 values; 3 of 7 patients had LGE. At intermediate follow-up, patients with C-VAM had fewer myocardial segments with LGE than patients with classic myocarditis (4/119 vs 42/340, P = .004). Patients with C-VAM also had a lower frequency of LGE (42.9 vs 75.0%) and lower percentage of left ventricular ejection fraction <55% compared with classic myocarditis (0.0 vs 30.0%), although these differences were not statistically significant. Five patients with classic myocarditis did not receive an early CMR, leading to some selection bias in study design.
Conclusions: Patients with C-VAM had no evidence of active inflammation or ventricular dysfunction on intermediate CMR, although a minority had persistent LGE. Intermediate findings in C-VAM revealed less LGE burden compared with classic myocarditis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171891 | PMC |
| http://dx.doi.org/10.1016/j.jpeds.2023.113462 | DOI Listing |
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