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Schroth D, Garg R, Bocova X, Hansmann J, Haass M, Yan A, Fernando C, Chacko B, Oikonomou A, White J, Alhussein MM, Giusca S, Ochs A, Korosoglou G, André F, Friedrich MG, Ochs M. Predictors of persistent symptoms after mRNA SARS-CoV-2 vaccine-related myocarditis (myovacc registry). Front Cardiovasc Med 2023; 10:1204232. [PMID: 37416926 PMCID: PMC10321411 DOI: 10.3389/fcvm.2023.1204232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Aims Epidemiological surveillance has raised safety concerns for mRNA SARS-CoV-2-vaccination-related myocarditis. We aimed to analyze epidemiological, clinical and imaging findings associated with clinical outcomes in these patients in an international multi-center registry (NCT05268458). Methods and results Patients with clinical and CMR diagnosis of acute myocarditis within 30 days after mRNA SARS-CoV-2-vaccination were included from five centers in Canada and Germany between 05/21 and 01/22. Clinical follow-up on persistent symptoms was collected. We enrolled 59 patients (80% males, mean age 29 years) with CMR-derived mild myocarditis (hs-Troponin-T 552 [249-1,193] ng/L, CRP 28 [13-51] mg/L; LVEF 57 ± 7%, LGE 3 [2-5] segments). Most common symptoms at baseline were chest pain (92%) and dyspnea (37%). Follow-up data from 50 patients showed overall symptomatic burden improvement. However, 12/50 patients (24%, 75% females, mean age 37 years) reported persisting symptoms (median interval 228 days) of chest pain (n = 8/12, 67%), dyspnea (n = 7/12, 58%), with increasing occurrence of fatigue (n = 5/12, 42%) and palpitations (n = 2/12, 17%). These patients had initial lower CRP, lower cardiac involvement in CMR, and fewer ECG changes. Significant predictors of persisting symptoms were female sex and dyspnea at initial presentation. Initial severity of myocarditis was not associated with persisting complaints. Conclusion A relevant proportion of patients with mRNA SARS-CoV-2-vaccination-related myocarditis report persisting complaints. While young males are usually affected, patients with persisting symptoms were predominantly females and older. The severity of the initial cardiac involvement not predicting these symptoms may suggest an extracardiac origin.
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Affiliation(s)
- Daniel Schroth
- Departments of Radiology and Cardiology, Theresien Hospital, Mannheim, Germany
| | - Ria Garg
- Departments of Medicine and Diagnostic Radiology, McGill University Health Centre (MUHC), Montreal, QC, Canada
| | - Xhoi Bocova
- Departments of Radiology and Cardiology, Theresien Hospital, Mannheim, Germany
| | - Jochen Hansmann
- Departments of Radiology and Cardiology, Theresien Hospital, Mannheim, Germany
| | - Markus Haass
- Departments of Radiology and Cardiology, Theresien Hospital, Mannheim, Germany
| | - Andrew Yan
- Division of Cardiology, Unity Health Toronto, St. Michael’s Hospital, Toronto, ON, Canada
| | - Carlos Fernando
- Division of Cardiology, Unity Health Toronto, St. Michael’s Hospital, Toronto, ON, Canada
| | - Binita Chacko
- Department of Medical Imaging, Sunnybrook Health Sciences Center, Toronto, ON, Canada
| | - Anastasia Oikonomou
- Department of Medical Imaging, Sunnybrook Health Sciences Center, Toronto, ON, Canada
| | - James White
- Stephenson Cardiac Imaging Centre, Foothills Medical Centre, Calgary, AB, Canada
| | | | - Sorin Giusca
- Department of Cardiology, GRN Hospital, Weinheim, Germany
| | - Andreas Ochs
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Florian André
- Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias G. Friedrich
- Departments of Medicine and Diagnostic Radiology, McGill University Health Centre (MUHC), Montreal, QC, Canada
| | - Marco Ochs
- Departments of Radiology and Cardiology, Theresien Hospital, Mannheim, Germany
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Schroth D, Garg R, Bocova X, Hansmann J, Haass M, Yan AT, Fernando C, Chacko BR, Oikonomou A, White JA, Alhussein MM, Giusca S, Ochs A, Korosoglou G, Friedrich MG, Ochs MM. PREDICTORS OF PERSISTENT SYMPTOMS AFTER MRNA SARS-COV-2 VACCINE-RELATED MYOCARDITIS (MYOVACC REGISTRY). J Am Coll Cardiol 2023. [PMCID: PMC9982916 DOI: 10.1016/s0735-1097(23)01823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Hein HJ, Czurratis P, Schroth D, Bernstein A. A comparative study of the application of scanning acoustic microscopy and confocal laser scanning microscopy to the structural assessment of human bones. Ann Anat 1995; 177:427-30. [PMID: 7645738 DOI: 10.1016/s0940-9602(11)80149-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The Scanning Acoustic Microscope (SAM) is used to image mechanical structure and to measure the sound velocity in micrometers of in vitro samples from human bone. A similar principle is used in confocal laser scanning microscopy. The same sample is imaged by both methods and the results compared. We concentrated on the SAM, the function of which is described in greater detail. We demonstrate that the confocal scanning principle is applied in both microscopes, although information about structure differs, depending on the method used.
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Affiliation(s)
- H J Hein
- Orthopädische Klinik, Medizinischen Fakultät, Universität Halle
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