Improvement of Symptoms and Cardiac Magnetic Resonance Abnormalities in Patients with Post-Acute Sequelae of SARS-CoV-2 Cardiovascular Syndrome (PASC-CVS) after Guideline-Oriented Therapy.
Mariann GyöngyösiEna HasimbegovicEmilie HanKatrin Müller-ZlabingerAndreas SpannbauerMartin RiesenhuberKevin HamzarajJutta Bergler-KleinChristian HengstenbergAndreas Anselm KammerlanderStefan KastlChristian LoeweDietrich BeitzkePublished in: Biomedicines (2023)
Cardiac magnetic resonance (CMR) studies reported CMR abnormalities in patients with mild-moderate SARS-CoV-2 infection, suggesting ongoing myocardial inflammation. Patients ( n = 278, 43 ± 13 years, 70.5% female) with post-acute sequelae of SARS-CoV-2 cardiovascular syndrome (PASC-CVS) were included prospectively into the Vienna POSTCOV Registry between March 2021 and March 2023 (clinicaltrials.gov NCT05398952). Clinical, laboratory, and CMR findings were recorded. Patients with abnormal CMR results were classified into isolated chronic pericardial (with/without pleural) effusion, isolated cardiac function impairment, or both (myopericarditis) groups. Medical treatment included a nonsteroidal anti-inflammatory agent (NSAID) for pericardial effusion and a condition-adapted maximal dose of heart failure (HF) treatment. Three months after medical therapy, clinical assessment and CMR were repeated in 82 patients. Laboratory analyses revealed normal hematological, inflammatory, coagulation, and cardiac biomarkers. CMR abnormalities were found in 155 patients (55.8%). Condition-adapted HF treatment led to a significant increase in the left ventricular ejection fraction (LVEF) in patients with initially reduced LVEF (from 49 ± 5% to 56 ± 4%, p = 0.009, n = 25). Low-moderate doses of NSAIDs for 3 months significantly reduced pericardial effusion (from 4/3;5.75/mm to 2/0;3/mm, median/interquartile ranges/ p < 0.001, n = 51). Clinical symptoms improved markedly with a decrease in CMR abnormalities, which might be attributed to the maintenance of NSAID and HF medical treatment for PASC-CVS.
Keyphrases
- ejection fraction
- left ventricular
- sars cov
- magnetic resonance
- heart failure
- end stage renal disease
- aortic stenosis
- newly diagnosed
- healthcare
- blood pressure
- liver failure
- prognostic factors
- stem cells
- hepatitis b virus
- single cell
- magnetic resonance imaging
- atrial fibrillation
- anti inflammatory
- bone marrow
- combination therapy
- mitral valve
- acute coronary syndrome
- patient reported
- high intensity
- cell therapy
- acute respiratory distress syndrome
- sleep quality
- transcatheter aortic valve replacement
- percutaneous coronary intervention