Magnetic resonance imaging-derived portrait of cardiac patients in one specialized cardiovascular center during COVID-19 pandemic

Abstract

Purpose. The objective of the study was to elucidate the impact of COVID-19 pandemic on cardiac magnetic resonance imaging (CMR)-derived portrait of a patient in one specialized cardiovascular center.Material and Methods. The study comprised 987 patients who underwent CMR with paramagnetic contrast enhancement in cardiovascular center from 01.01.2019 to 01.06.2022. Data were obtained from electronic medical records stored in the electronic module keeping track of instrumental studies. Data contained information on type and characteristics of protocol, referring department, clinical and demographic patient characteristics, and diagnosis. Gender, age, type of visit (ambulatory, in-hospital), instrumental data, and unstructured text were analyzed. Contrast-enhanced CMR was performed according to standard method using 1.5-Tesla MRI system Vantage Titan 1.5T (Toshiba Medical Systems) with ECG-synchronization.Results. Proportion of CMR among all MRI studies increased during the study period. Maximum number of cardiac diseases was detected in 2021. Incidence of fibrosis-dystrophic myocardial changes increased from 67.17% in 2019 to 84.14% in 2022 potentially due to the past cardiac inflammation. Patient numbers in each age group peaked in 2021, and the highest incidence rate was observed in the group of 60-69-year-old patients with high risk for severe COVID-19 course and complications. In 2020, the incidence of acute myocarditis significantly decreased to 10% in men and 13% in women and then gradually increased in 2021. The rate of ambulatory visits significantly increased in 2020, but returned to the pre-pandemic level in 2021.Conclusion. COVID-19 pandemic increased the need for CMR. Patients with history of COVID-19 had persistent and newly occurring symptoms of myocardial damage suggesting chronic cardiac involvement. Regional myocardial fibrosis was the main COVID-19-associated presentation on contrast-enhanced CMR. Continuous follow-up of patients is required to assess their risk for the left ventricular remodeling.