Myocardial Tissue Characterization in Cardiac Magnetic Resonance Studies of Patients Recovering From COVID-19: A Meta-Analysis

Author(s)

Jerosch-Herold, Michael ; Rickers, Carsten ; Petersen, Steffen E. E. ; Coelho-Filho, Otavio R.

• Document type: Journal article
• Source: JOURNAL OF THE AMERICAN HEART ASSOCIATION; v. 12, n. 6, p. 22-pg., 2023-03-21.

Abstract

BackgroundMeta-analysis can identify biological factors that moderate cardiac magnetic resonance myocardial tissue markers such as native T-1 (longitudinal magnetization relaxation time constant) and T-2 (transverse magnetization relaxation time constant) in cohorts recovering from COVID-19 infection. Methods and ResultsCardiac magnetic resonance studies of patients with COVID-19 using myocardial T-1, T-2 mapping, extracellular volume, and late gadolinium enhancement were identified by database searches. Pooled effect sizes and interstudy heterogeneity (I-2) were estimated with random effects models. Moderators of interstudy heterogeneity were analyzed by meta-regression of the percent difference of native T-1 and T-2 between COVID-19 and control groups (%Delta T-1 [percent difference of the study-level means of myocardial T-1 in patients with COVID-19 and controls] and %Delta T-2 [percent difference of the study-level means of myocardial T-2 in patients with COVID-19 and controls]), extracellular volume, and the proportion of late gadolinium enhancement. Interstudy heterogeneities of %Delta T-1 (I-2=76%) and %Delta T-2 (I-2=88%) were significantly lower than for native T-1 and T-2, respectively, independent of field strength, with pooled effect sizes of %Delta T-1=1.24% (95% CI, 0.54%-1.9%) and %Delta T-2=3.77% (95% CI, 1.79%-5.79%). %Delta T-1 was lower for studies in children (median age: 12.7 years) and athletes (median age: 21 years), compared with older adults (median age: 48 years). Duration of recovery from COVID-19, cardiac troponins, C-reactive protein, and age were significant moderators for %Delta T-1 and/or %Delta T-2. Extracellular volume, adjusted by age, was moderated by recovery duration. Age, diabetes, and hypertension were significant moderators of the proportion of late gadolinium enhancement in adults. ConclusionsT(1) and T-2 are dynamic markers of cardiac involvement in COVID-19 that reflect the regression of cardiomyocyte injury and myocardial inflammation during recovery. Late gadolinium enhancement and to a lesser extent extracellular volume, are more static biomarkers moderated by preexisting risk factors linked to adverse myocardial tissue remodeling. (AU)

• FAPESP's process: 17/03708-5 - Multi-user equipament approved in the grant 2015/15402-2: ecocardiograma
• Grantee: Otávio Rizzi Coelho-Filho
• Support Opportunities: Multi-user Equipment Program
• FAPESP's process: 16/26209-1 - Multi-user equipament approved in grat 2015/15402-2: cardiorespiratory diagnostic system
• Grantee: Otávio Rizzi Coelho-Filho
• Support Opportunities: Multi-user Equipment Program
• FAPESP's process: 15/15402-2 - Characterization of interstitial fibrosis and cardiomyocyte hypertrophy by cardiac MRI: implication on early remodeling and on the transition to heart failure
• Grantee: Otávio Rizzi Coelho-Filho
• Support Opportunities: Research Grants - Young Investigators Grants