The Correlation between Cardiac Magnetic Resonance Findings and Post-COVID-19: The Impact of Myocardial Injury on Quality of Life
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Cardiac MRI: Protocol and Image Analysis
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | (n = 85) |
---|---|
Age, mean ± sd | 42.5 ± 13.4 |
Gender, n (%) | |
Male | 26 (30.6) |
Female | 59 (69.4) |
BMI, mean ± sd | 25.9 ± 4.3 |
Hypertension, n (%) | 17 (20.0) |
Diabetes mellitus, n (%) | 10 (11.8) |
COPD, n (%) | 1 (1.2) |
Systemic connective tissue or inflammatory diseases, n (%) | 2 (2.4) |
Variable | |
---|---|
Number of days from onset of symptoms to CMR, median (interquartile range) | 120 (51–209) |
Number of days with cardiovascular problems | |
<12 weeks | 7 (8.2) |
≥12 weeks | 78 (91.8) |
Treatment, n (%) | |
Home treatment | 46 (54.1) |
Hospital treatment | 39 (45.9) |
Oxygen therapy, n (%) | 30 (35.3) |
Mechanic ventilation, n (%) | 2 (2.4) |
Pneumonia as a part of COVID-19 infection, n (%) | 47 (55.3) |
The main cardiac symptoms in post-COVID-19 period, n (%) | |
Palpitations | 53 (62.4) |
Irregular heartbeat | 38 (44.7) |
Fatigue | 69 (81.2) |
Shortness or loss of breath | 28 (32.9) |
Chest pain | 22 (25.9) |
Fever | 11 (12.9) |
Dizziness and fainting | 6 (7.1) |
Unconsciousness | 2 (2.4) |
Recurrent episode of hospitalization during the period of cardiac symptoms, n (%) | 9 (10.6) |
Quality of life, mean (95% CI) | 5.2 (4.7-5.8) |
Severeness of symptoms, n (%) | |
During acute infection | 36 (42.4) |
Post-COVID-19 | 49 (57.6) |
Variable | |
---|---|
EF LV, mean ± sd, % | 61.43 ± 5.87 |
EF RV, mean ± sd, % | 60.65 ± 7.83 |
EDVI LV, n (%) | |
Elevated | 20 (23.5) |
SVI LV, n (%) | |
Decreased | 3 (3.5) |
CI LV, n (%) | |
Decreased | 1 (1.2) |
Myocardial mass index LV in ED, n (%) | |
Increased | 0 (0.0) |
Average myocardial mass index LV, n (%) | |
Increased | 0 (0.0) |
Variable | |
---|---|
LGE, n (%) | 67 (78.8) |
Myocardial segments involved by LGE, n (%) | |
Basal anterior | 5 (5.9) |
Basal anteroseptal | 3 (3.5) |
Basal inferoseptal | 6 (7.1) |
Basal inferior | 17 (20.0) |
Basal inferolateral | 22 (25.9) |
Basal anterolateral | 11 (12.9) |
Mid anterior | 2 (2.4) |
Mid anteroseptal | 5 (5.9) |
Mid inferoseptal | 10 (11.8) |
Mid inferior | 10 (11.8) |
Mid inferolateral | 40 (47.1) |
Mid anterolateral | 29 (34.1) |
Apical anterior | 1 (1.2) |
Apical septal | 0 (0.0) |
Apical inferior | 3 (3.5) |
Apical lateral | 3 (3.5) |
Quantification of LGE (%) | |
0 | 18 (21.7) |
1 | 37 (44.6) |
2 | 23 (27.7) |
3 | 5 (6.0) |
Distribution of LGE, n (%) | |
Subepicardial | 27 (31.8) |
Mid-wall | 7 (8.2) |
Transmural | 1 (1.2) |
Subepicardial and mid-wall | 32 (37.6) |
Late pericardial enhancement, n (%) | 34 (40.0) |
Variable | |
---|---|
Mean native T1 value (diffuse), mean ± sd | 1020 ± 35 |
Mean T2 value (diffuse), mean ± sd | 47 ± 3 |
Highest mean native T1 value (focal), mean ± sd | 1174 ± 106 |
Highest mean T2 value (focal), mean ± sd | 58 ± 9 |
ECV, mean ± sd | 25.7 ± 1.9 |
Pericardial effusion, n (%) | 44 (51.8) |
Variable | Oxygen Therapy, MV, or Pneumonia | p Value | |
---|---|---|---|
No (n = 36) | Yes (n = 49) | ||
Age, mean ± sd | 34.3 ± 10.4 | 48.5 ± 12.2 | <0.001 |
Gender, n (%) | |||
Male | 11 (30.6) | 15 (30.6) | 0.996 |
Female | 25 (69.4) | 34 (69.4) | |
BMI, mean ± sd | 24.3 ± 3.2 | 27.1 ± 4.5 | 0.002 |
Hypertension, n (%) | 2 (5.6) | 15 (30.6) | 0.004 |
Diabetes mellitus, n (%) | 1 (2.8) | 9 (18.4) | 0.028 |
COPD, n (%) | 0 (0.0) | 1 (2.0) | 1.000 |
Systemic connective tissue or inflammatory diseases, n (%) | 0 (0.0) | 2 (4.1) | 0.506 |
Quality of life, mean (95% CI) | 5.5 (4.5–6.5) | 5.0 (4.3–5.8) | 0.437 |
EF LV, mean ± sd | 61.7 ± 5.6 | 61.2 ± 6.1 | 0.699 |
EF RV, mean ± sd | 60.2 ± 6.1 | 61.0 ± 8.9 | 0.646 |
LGE, n (%) | 31 (86.1) | 36 (73.5) | 0.159 |
Number of segments with LGE, median (interquartile range) | 2 (1–3) | 2 (0–3) | 0.796 |
Myocardial segments involved by LGE, n (%) | |||
Basal anterior | 5 (13.9) | 0 (0.0) | 0.007 |
Basal anteroseptal | 1 (2.8) | 2 (4.1) | 0.748 |
Basal inferoseptal | 1 (2.8) | 5 (10.2) | 0.187 |
Basal inferior | 7 (19.4) | 10 (20.4) | 0.913 |
Basal inferolateral | 7 (19.4) | 15 (30.6) | 0.245 |
Basal anterolateral | 6 (16.7) | 5 (10.2) | 0.380 |
Mid anterior | 0 (0.0) | 2 (4.1) | 0.220 |
Mid anteroseptal | 2 (5.6) | 3 (6.1) | 0.913 |
Mid inferoseptal | 5 (13.9) | 5 (10.2) | 0.602 |
Mid inferior | 5 (13.9) | 5 (10.2) | 0.602 |
Mid inferolateral | 17 (47.2) | 23 (46.9) | 0.979 |
Mid anterolateral | 15 (41.7) | 14 (28.6) | 0.208 |
Apical anterior | 1 (2.8) | 0 (0.0) | 0.241 |
Apical inferior | 0 (0.0) | 3 (6.1) | 0.131 |
Apical lateral | 0 (0.0) | 3 (6.1) | 0.131 |
Quantification of LGE (%) | |||
≤1 | 24 (66.7) | 31 (66.0) | 0.946 |
>1 | 12 (33.3) | 16 (34.0) | |
Late pericardial enhancement, n (%) | 15 (41.7) | 19 (38.8) | 0.788 |
Mean native T1 value (diffuse), mean ± sd | 1015.7 ± 36.0 | 1022.4 ± 34.3 | 0.386 |
Mean T2 value (diffuse), mean ± sd | 46.7 ± 2.8 | 47.6 ± 3.9 | 0.270 |
Highest mean native T1 value (focal), mean ± sd | 1162.5 ± 117.4 | 1181.6 ± 96.4 | 0.412 |
Highest mean T2 value (focal), mean ± sd | 58.6 ± 10.2 | 57.8 ± 7.1 | 0.647 |
ECV, mean ± sd | 25.7 ± 1.9 | 25.6 ± 1.9 | 0.819 |
Pericardial effusion, n (%) | 22 (61.1) | 22 (44.9) | 0.139 |
Variable | Pericardial Effusion | p Value | |
---|---|---|---|
No (n = 41) | Yes (n = 44) | ||
Age, mean ± sd | 46.2 ± 12.9 | 39.0 ± 13.1 | 0.013 |
Gender, n (%) | |||
Male | 19 (46.3) | 7 (15.9) | 0.002 |
Female | 22 (53.7) | 37 (84.1) | |
BMI, mean ± sd | 27.5 ± 4.4 | 24.5 ± 3.6 | 0.001 |
Hypertension, n (%) | 13 (31.7) | 4 (9.1) | 0.009 |
Diabetes mellitus, n (%) | 6 (14.6) | 4 (9.1) | 0.428 |
COPD, n (%) | 1 (2.4) | 0 (0.0) | 0.297 |
Systemic connective tissue or inflammatory diseases, n (%) | 0 (0.0) | 2 (4.5) | 0.167 |
Quality of life, mean (95% CI) | 5.8 (5.0–6.7) | 4.7 (3.9–5.5) | 0.049 |
EF LV, mean ± sd | 61.7 ± 7.2 | 61.2 ± 4.4 | 0.720 |
EF RV, mean ± sd | 58.4 ± 8.9 | 62.6 ± 6.1 | 0.019 |
EDVI LV, n (%) | |||
Decreased/normal values | 32 (80.0) | 32 (72.7) | 0.434 |
Elevated | 8 (20.0) | 12 (27.3) | |
SVI LV, n (%) | |||
Decreased/normal values | 38 (95.0) | 40 (90.9) | 0.467 |
Elevated | 2 (5.0) | 4 (9.1) | |
CI LV, n (%) | |||
Decreased/normal values | 35 (87.5) | 39 (88.6) | 0.872 |
Elevated | 5 (12.5) | 5 (11.4) | |
Myocardial mass index LV in ED, n (%) | |||
Decreased | 22 (55.0) | 23 (52.3) | 0.802 |
Normal values | 18 (45.0) | 21 (47.7) | |
Average myocardial mass index LV, n (%) | |||
Decreased | 24 (60.0) | 26 (59.1) | 0.932 |
Normal values | 16 (40.0) | 18 (40.9) | |
LGE, n (%) | 31 (75.6) | 36 (81.8) | 0.484 |
Number of segments with LGE, median (interquartile range) | 2 (1–3) | 2 (1–3) | 0.673 |
Myocardial segments involved by LGE, n (%) | |||
Basal anterior | 2 (4.9) | 3 (6.8) | 0.704 |
Basal anteroseptal | 2 (4.9) | 1 (2.3) | 0.515 |
Basal inferoseptal | 3 (7.3) | 3 (6.8) | 0.929 |
Basal inferior | 9 (22.0) | 8 (18.2) | 0.664 |
Basal inferolateral | 14 (34.1) | 8 (18.2) | 0.093 |
Basal anterolateral | 6 (14.6) | 5 (11.4) | 0.654 |
Mid anterior | 2 (4.9) | 0 (0.0) | 0.138 |
Mid anteroseptal | 2 (4.9) | 3 (6.8) | 0.704 |
Mid inferoseptal | 1 (2.4) | 9 (20.5) | 0.010 |
Mid inferior | 4 (9.8) | 6 (13.6) | 0.579 |
Mid inferolateral | 16 (39.0) | 24 (54.5) | 0.152 |
Mid anterolateral | 15 (36.6) | 14 (31.8) | 0.643 |
Apical anterior | 0 (0.0) | 1 (2.3) | 0.332 |
Apical inferior | 0 (0.0) | 3 (6.8) | 0.089 |
Apical lateral | 2 (4.9) | 1 (2.3) | 0.515 |
Quantification of LGE (%) | |||
≤1 | 27 (67.5) | 28 (65.1) | 0.818 |
>1 | 13 (32.5) | 15 (34.9) | |
Late pericardial enhancement, n (%) | 13 (31.7) | 21 (47.7) | 0.132 |
Mean native T1 value (diffuse), mean ± sd | 1011 ± 30.4 | 1027.5 ± 37.3 | 0.029 |
Mean T2 value (diffuse), mean ± sd | 47.3 ± 3.8 | 47.1 ± 3.2 | 0.836 |
Highest mean native T1 value (focal), mean ± sd | 1186.1 ± 94.4 | 1161.8 ± 114.9 | 0.292 |
Highest mean T2 value (focal), mean ± sd | 58.1 ± 6.6 | 58.2 ± 10.0 | 0.965 |
ECV, mean ± sd | 25.5 ± 1.4 | 25.9 ± 2.2 | 0.399 |
Variable | More Severe Symptoms | p Value | |
---|---|---|---|
COVID-19 (n = 36) | POST-COVID-19 (n = 49) | ||
Age, mean ± sd | 46.4 ± 13.3 | 39.6 ± 13.0 | 0.022 |
Gender, n (%) | |||
Male | 16 (44.4) | 10 (20.4) | 0.017 |
Female | 20 (55.6) | 39 (79.6) | |
BMI, mean ± sd | 27.1 ± 3.1 | 25.0 ± 4.8 | 0.023 |
Hypertension, n (%) | 12 (33.3) | 5 (10.2) | 0.008 |
Diabetes mellitus, n (%) | 6 (16.7) | 4 (8.2) | 0.229 |
COPD, n (%) | 0 (0.0) | 1 (2.0) | 0.389 |
Systemic connective tissue or inflammatory diseases, n (%) | 1 (2.8) | 1 (2.0) | 0.825 |
Quality of life, mean (95% CI) | 6.4 (5.5–7.3) | 4.4 (3.7–5.1) | <0.001 |
EF LV, mean ± sd | 61.7 ± 4.1 | 61.3 ± 6.9 | 0.755 |
EF RV, mean ± sd | 58.9 ± 7.2 | 62.0 ± 8.1 | 0.081 |
LGE, n (%) | 30 (83.3) | 37 (75.5) | 0.383 |
Number of segments with LGE, median (interquartile range) | 2 (1–3) | 2 (1–3) | 0.380 |
Myocardial segments involved by LGE, n (%) | |||
Basal anterior | 0 (0.0) | 5 (10.2) | 0.048 |
Basal anteroseptal | 2 (5.6) | 1 (2.0) | 0.386 |
Basal inferoseptal | 3 (8.3) | 3 (6.1) | 0.694 |
Basal inferior | 7 (19.4) | 10 (20.4) | 0.913 |
Basal inferolateral | 12 (33.3) | 10 (20.4) | 0.179 |
Basal anterolateral | 5 (13.9) | 6 (12.2) | 0.823 |
Mid anterior | 1 (2.8) | 1 (2.0) | 0.825 |
Mid anteroseptal | 3 (8.3) | 2 (4.1) | 0.410 |
Mid inferoseptal | 2 (5.6) | 8 (16.3) | 0.128 |
Mid inferior | 3 (8.3) | 7 (14.3) | 0.400 |
Mid inferolateral | 19 (52.8) | 21 (42.9) | 0.365 |
Mid anterolateral | 15 (41.7) | 14 (28.6) | 0.208 |
Apical anterior | 0 (0.0) | 1 (2.0) | 0.389 |
Apical inferior | 1 (2.8) | 2 (4.1) | 0.748 |
Apical lateral | 3 (8.3) | 0 (0.0) | 0.040 |
Quantification of LGE (%) | |||
≤1 | 22 (62.9) | 33 (68.8) | 0.575 |
>1 | 13 (37.1) | 15 (31.3) | |
Late pericardial enhancement, n (%) | 15 (41.7) | 19 (38.8) | 0.788 |
Mean native T1 value (diffuse), mean ± sd | 1014.5 ± 35.7 | 1023.2 ± 34.3 | 0.261 |
Mean T2 value (diffuse), mean ± sd | 46.5 ± 3.1 | 47.7 ± 3.7 | 0.135 |
Highest mean native T1 value (focal), mean ± sd | 1186.1 ± 91.5 | 1164.2 ± 114.9 | 0.348 |
Highest mean T2 value (focal), mean ± sd | 57.9 ± 6.2 | 58.3 ± 9.9 | 0.797 |
ECV, mean ± sd | 25.3 ± 1.0 | 26.0 ± 1.0 | 0.106 |
Pericardial effusion, n (%) | 11 (30.6) | 33 (67.3) | 0.001 |
Variable | Multivariate Linear Regression Analysis | ||
---|---|---|---|
β | t | p Value | |
Irregular heartbeat | −0.232 | −2.228 | 0.039 |
Cardiovascular problems that lasts longer than 12 weeks | −0.251 | −2.408 | 0.018 |
Pericardial effusion | −0.218 | −2.117 | 0.037 |
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Popovic, M.; Cvetic, V.; Popadic, V.; Ilic, K.; Radojevic, A.; Klasnja, A.; Milic, N.; Rajovic, N.; Lasica, R.; Gostiljac, D.; et al. The Correlation between Cardiac Magnetic Resonance Findings and Post-COVID-19: The Impact of Myocardial Injury on Quality of Life. Diagnostics 2024, 14, 1937. https://doi.org/10.3390/diagnostics14171937
Popovic M, Cvetic V, Popadic V, Ilic K, Radojevic A, Klasnja A, Milic N, Rajovic N, Lasica R, Gostiljac D, et al. The Correlation between Cardiac Magnetic Resonance Findings and Post-COVID-19: The Impact of Myocardial Injury on Quality of Life. Diagnostics. 2024; 14(17):1937. https://doi.org/10.3390/diagnostics14171937
Chicago/Turabian StylePopovic, Maja, Vladimir Cvetic, Viseslav Popadic, Kristina Ilic, Aleksandra Radojevic, Andrea Klasnja, Natasa Milic, Nina Rajovic, Ratko Lasica, Drasko Gostiljac, and et al. 2024. "The Correlation between Cardiac Magnetic Resonance Findings and Post-COVID-19: The Impact of Myocardial Injury on Quality of Life" Diagnostics 14, no. 17: 1937. https://doi.org/10.3390/diagnostics14171937