Cardiac MRI Finds Lower Levels of Myocarditis in Athletes Recovering from COVID-19
Diagnostic Imaging published a piece on an important study comparing athletes who had Covid-19 with healthy controls and found lower levels of heart muscle inflammation, or “myocarditis”, than previously believed.
The study, published by the American Heart Association, and conducted by researchers from the Vanderbilt University Medical Center, found that only 3% of a group of the 59 athletes that the study evaluated had any lasting effects on their heart. The study will appear in the February edition of Circulation. Dr. Dan Clark, an instructor of cardiovascular medicine at the Medical Centre and the lead author of the study, explained that since this study, the team had screened nearly double the size of the first group and found that the findings from the initial study still held true.
This is the first time that healthy controls have been used in assessing athletes recovering from Covid-19. Given the improved methodology, it is safe to assume that athletes recovering from Covid-19 will have lower degrees of myocarditis than initial studies and reporting had led us to believe.
The results of the first study had been extremely discomorting and shocking, and had profound implications on the world of sport, which had to grapple with the implications of athletes having such high degrees of myocarditis and edema.
As positive as these findings are, they do contain some black marks. The study was unable to narrow things down and tell the researchers which athletes exactly had myocarditis, despite subjecting the athletes to numerous screening tests. Prior to this study, all these athletes had been Covid-19 asymptomatic.
This was especially disappointing because the researchers had hoped that normal screening would be sufficient to detect myocarditis, circumventing the need for a cardiac MRI.
Given that the athletes all had normal cardiovascular screening, blood work, clinical exams, echocardiograms, and EKGs, it is obvious that relying on screening tests would have led doctors to give athletes a clean bill of health and allowing them to compete, whereas MRIs would have given a very different picture.
The study also found greater levels of scarring in healthy heart muscle than was expected. When the team compared cardiac MRI scans of Covid-19 positive athletes with those of healthy controls, they found that the two had roughly similar levels of scarring, with 27% of healthy controls and 24% of the Covid-19 positive athletes showing scarring. The study concluded that the scarring was benign, common among athletes and due to athletic remodeling.
Clearly access to Express MRI is important in studying the effects of Covid-19. The study determined that without an MRI comparing Covid-19 positive athletes with healthy controls, they would have assumed that the scarring was due to Covid-19, rather than a benign consequence of athletic remodeling. They would then have unnecessarily restricted athletes with scarring from competition.
MRIs will continue to be an important tool in assessing athletes and helping regulators draft guidelines.