Two long-term studies found signs of fibrosis in patients who suffered heart inflammation after getting a COVID-19 shot.
Heart scarring was detected more than one year after COVID-19 vaccination in some people who suffered myocarditis following receipt of a shot, researchers reported in new studies.
A third of 60 patients with follow-up cardiac imaging done more than 12 months after their myocarditis diagnosis had persistent late gadolinium enhancement (LGE), which is, in the majority of cases, reflective of heart scarring, Australian researchers reported in a preprint of a new study, published on March 22.
Myocarditis is a form of heart inflammation.
The median time from receipt of a vaccine to follow-up imaging was 548 days, with the longest interval being 603 days.
“We found that the incidence of persistent myocardial fibrosis is high, seen in almost a third of patients at 12 months post diagnosis, which could have implications for the management and prognosis of this predominantly young cohort,” the researchers wrote.
“The long-term clinical implications of LGE in this condition are as yet unknown, but LGE has been demonstrated to confer worse prognosis in non-COVID-19 vaccine-associated myocarditis, especially if it persists beyond six months,” they added later, pointing to severalpreviouspapers.
Researchers in one of the previous papers, for instance, found that LGE was a “powerful prognosticator” of adverse outcomes in myocarditis patients.
Before the new testing, nine patients were determined to definitely have myocarditis, and 58 patients were labeled as probably having myocarditis. The findings of persistent LGE resulted in reclassifying 16 of the cases from probable myocarditis to definite myocarditis.
Exclusions included patients who were pregnant or allergic to agents used in gadolinium testing.
Among a subset of 20 patients who underwent imaging shortly after vaccination, 19 had LGE. In follow-up imaging, LGE was no longer visible in 10 of those patients. In five, it was reduced, but in four it was unchanged.
Andrew Taylor, a professor at Monash University’s Central Clinical School, and his co-authors conducted the study by recruiting patients who were diagnosed with myocarditis associated with COVID-19 vaccination between August 2021 and March 2022. The patients were invited to undergo imaging at Alfred Hospital or Royal Children’s Hospital in Melbourne, Australia.
