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Cardiac scan after asymptomatic COVID: not a good idea

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Cardiac MRI (CMR) can find abnormalities suggestive of myocarditis after recovery of COVID-19-or can rule out-but in the absence of symptoms, cardiologists, radiologists, and others Insisted.

“We would like to emphasize that the prevalence, clinical significance, and long-term effects of CMR surrogate on myocardial injury on morbidity and mortality are unknown,” they write. An open letter signed by about 50 healthcare professionals From various fields.

Until better evidence, the group argued that “testing asymptomatic civilians after COVID-19 is shown only in carefully planned and approved studies by appropriate control groups.” ..

The letter called on 18 professional societies, including the American Heart Association (ACC), the American Heart Association, and the American Society of Radiology, to provide clear guidance to stop people seeking CMR screening for that purpose.

The controversy is German learning Late gadolinium enhancement and suggestion of myocardial damage and inflammation in a group of people whose majority of COVID-19 recovered from mild or moderate cases compared to healthy controls and controls with matching risk factors Other anomalies were found.

After that, Ohio State University researchers said last week CMR scan of college athletes After asymptomatic or mild SARS-CoV-2 infection: 15% have findings suggestive of myocarditis and 31% have LGE without T2 elevation, suggesting previous myocardial damage.

Both studies prove that COVID-19 caused the anomaly, Long-term impact Will be. But both were used to make decisions about Sports safety..

German group Pay attention to the interpretation.. However, Ohio researchers write that CMRs may be able to separate themselves from safe athletes by joining high-risk groups. “The CMR mapping technique has high negative predictions to rule out myocarditis.” Bloomberg Talking about Ohio data calls it “Call to screen college athletes

Ohio Football Fan Site, 11 warriors, Lobbying the game to go as planned. Received the latest research as good news.. Lead author MD Saurabh Rajpal said, “If MRI does not show myocarditis in the heart, OSU will be an athlete. [recovering from COVID-19] I will return to practice. If the MRI is negative, you are allowed to return to normal intensity exercise. “

According to the letter, it’s a bad idea for the general public, who said people are looking for CMRs for asymptomatic screening.

“In my personal opinion, it includes casual athletics but not elite athletes,” said the first author of the letter from Venkatesh Murthy, MD, PhD at the University of Michigan in Ann Arbor. Today’s MedPage..

Consensus guidance From ACC’s Sports & Exercise Cardiology Council, on return to play, normalization of ventricular function, lack of evidence of biomarker-induced inflammation, and lack of inducible arrhythmia with risk stratification after 3-6 months of exercise restriction , And “Stress testing, rhythm monitoring based on extensive testing including echocardiography.”

For athletes, even asymptomatic infections, “if you are concerned about heart involvement, you should consider a heart test,” the guidance said.

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