A recent study has revealed that cardiac pathology 6 months following moderate-to-severe coronavirus disease or COVID-19 is present in about a fifth of the patients.
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What is Cardiac Pathology?
Cardiac pathology is defined as a collection of
diseases or conditions that involve the heart or blood vessels. A
cardiovascular disease (CVD) includes coronary artery disease or CAD such as myocardial
infarction and angina. There are other diseases such as heart arrhythmia,
valvular heart disease, and congenital heart diseases.
Research covered 58 COVID-19 survivors with median age
of 56 years old where 56% of them were men, who had undergone cardiovascular
magnetic resonance imaging or CMR where a median of 175 days following
recovery. There are abnormal CMR findings included the presence of late gadolinium
enhancement or LGE, which is indicative of myocardial scarring, or a left
ventricular ejection fraction or LVEF.
Following the exclusion of 3 patients because of the
unevaluable CMR sequences and underlying kidney disease, the experts found 12
patients who had abnormal CMR, generating a prevalence rate of 21%.
There were 3 patients who had major myocardial
pathology: one with both myocardial scarring and LVEF reduction to 38%; another
one without scarring but with LVEF decrease to 37%; and the last patient with
uncertain evidence of LGE together with an LVEF decrease to 39%. Remaining 9
patients were deemed to have minor pathologies found.
Comparing the results with the control group, patients
who developed CMR pathologies had comparable COVID-19 severity. Among the 11
patients who suffered severe COVID-19 requiring mechanical ventilation, only
one patient developed CMR abnormalities.
Meanwhile, serum levels of cardiac troponin-T and
N-terminal pro-B-type natriuretic peptide, though not only NT-proBNP remained relevant
after multivariable adjustment.
According to the researchers, that they found no
association between markers of disease severity during the index
hospitalization and pathology on CMR after 6 months, suggesting that
pre-existing subclinical myocardial disease may be more important than COVID-19
for the observed CMR pathology.
Source: Am Heart J 2021;doi:10.1016/j.ahj.2021.08.001