BACKGROUND Myocardial scars detected by cardiovascular magnetic resonance (CMR) imaging after COVID-19 have caused concerns regarding potential long-term cardiovascular consequences. OBJECTIVE The objective of this study was to investigate cardiopulmonary functioning in patients with versus without COVID-19-related myocardial scars. METHODS In this prospective cohort study, CMR was performed approximately 6 months after moderate-to-severe COVID-19. Before (∼3 months post-COVID-19) and after (∼12 months post-COVID-19) the CMR, patients underwent extensive cardiopulmonary testing with cardiopulmonary exercise tests, 24-h ECG, and echocardiography. We excluded participants with overt heart failure. RESULTS Post-COVID-19 CMR was available in 49 patients with cardiopulmonary tests at 3 and 12 months after the index hospitalization. Nine (18%) patients had small late gadolinium enhancement-detected myocardial scars. Patients with myocardial scars were older (63.2 ± 13.2 vs. 56.2 ± 13.2 years) and more frequently men (89% vs. 55%) compared to those without scars. Cardiorespiratory fitness was similar in patients with and without scars, i.e., peak oxygen uptake: 82.1 ± 11.5% versus 76.3 ± 22.5% of predicted, respectively (p = 0.46). The prevalence of ventricular premature contractions and arrhythmias was low and not different by the presence of myocardial scar. Cardiac structure and function assessed by echocardiography were similar between the groups, except for a tendency of greater left ventricular mass in those with scars (75 ± 20 vs. 62 ± 14, p = 0.02 and p = 0.08 after adjusting for age and sex). There were no significant associations between myocardial scar and longitudinal changes in cardiopulmonary function from 3 to 12 months. CONCLUSION Our findings imply that the presence of minor myocardial scars has limited clinical significance with respect to cardiopulmonary function after COVID-19.

中文翻译：

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COVID-19 后与心肺功能相关的轻微心肌疤痕。

背景 COVID-19 后通过心血管磁共振 (CMR) 成像检测到的心肌疤痕引起了人们对潜在的长期心血管后果的担忧。目的 本研究的目的是调查有与无 COVID-19 相关心肌疤痕患者的心肺功能。方法 在这项前瞻性队列研究中，CMR 是在中度至重度 COVID-19 感染后约 6 个月进行的。在 CMR 之前（COVID-19 后约 3 个月）和之后（COVID-19 后约 12 个月），患者接受了广泛的心肺测试，包括心肺运动测试、24 小时心电图和超声心动图。我们排除了患有明显心力衰竭的参与者。结果 49 名患者在首次住院后 3 个月和 12 个月时进行了心肺检查，获得了 COVID-19 后 CMR。九名 (18%) 患者有晚期钆增强检测到的小心肌疤痕。与无疤痕患者相比，有心肌疤痕的患者年龄较大（63.2 ± 13.2 岁 vs. 56.2 ± 13.2 岁），男性比例更高（89% vs. 55%）。有疤痕和无疤痕患者的心肺健康相似，即峰值摄氧量：分别为预测值的 82.1 ± 11.5% 和 76.3 ± 22.5%（p = 0.46）。室性早搏和心律失常的发生率较低，并且与心肌疤痕的存在没有差异。通过超声心动图评估的心脏结构和功能在各组之间相似，除了有疤痕的患者左心室质量有更大的趋势（75 ± 20 vs. 62 ± 14，调整年龄和性别后，p = 0.02 和 p = 0.08） 。心肌疤痕与 3 至 12 个月心肺功能的纵向变化之间没有显着相关性。结论 我们的研究结果表明，轻微心肌疤痕的存在对于 COVID-19 后心肺功能的临床意义有限。