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Assessment of myocardial injury by SPECT myocardial perfusion imaging in patients with COVID-19 infection in a single center after lifting the restrictions in China

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Abstract

Purpose

To assess myocardial injury using rest single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients with COVID-19 and to evaluate whether myocardial injury detected by rest MPI predict the prognosis of symptoms after 6 months follow-up.

Methods

Patients suspected of myocarditis between December 2022 and March 2023, after the lifting of COVID-19 pandemic restrictions, and between December 2018 and March 2019, prior to the pandemic, were referred to our study. All patients underwent rest MPI. One hundred and sixty four patients with COVID-19 infection after the lifting of pandemic restrictions and 101 patients before the pandemic were included as the study and control groups, respectively. One hundred and fifty three patients of the study group and 83 of the control group presented symptoms when they initially visit to our department. Compare the parameters of myocardial injury detected by rest SPECT MPI between the two groups and then investigate the association between myocardial injury and symptom prognosis in symptomatic patients of both groups.

Results

Total perfusion defect (TPD) (4.2% ± 3.3% vs. 2.3% ± 2.2%, P < 0.001), summed rest score (SRS) (5.3 ± 5.4 vs. 2.7 ± 2.0, P < 0.001), the proportion of patients with TPD > 4% (43.3% vs. 17.8%, P < 0.001), TPD > 10% (6.71% vs 0, P < 0.001), SRS > 4 (40.2% vs 15.8%, P < 0.001), SRS > 10 (12.8% vs 0, P < 0.001), the number of abnormal perfusion segments (3.9 ± 3.1 vs. 2.4 ± 1.7, P < 0.001) were all significantly higher in the study group. All the parameters of rest MPI were not associated with the prognosis of symptoms in symptomatic patients of both groups after 6 months follow-up.

Conclusion

Myocardial injury in COVID-19 patients could be assessed by rest SPECT MPI. The COVID-19 patients could exhibited a higher frequency and greater severity of myocardial injury than uninfected control patients. Myocardial injury assessed by rest MPI did not predict for the prognosis of symptoms in symptomatic patients of both COVID-19 patients and uninfected patients.

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Availability of data and material

The data and material that support the findings of this study are available on request from the corresponding authors.

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Author notes

  1. Keke Xin, Xinghong Ma, Jing Wang and Guoquan Li have contributed equally to this article.

Authors and Affiliations

  1. Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, No. 127 Changle West Road, Xincheng District, Xi’an, Shaanxi, 710032, China

    Keke Xin, Xiaoli Meng, Weidong Yang, Taoqi Ma, Cheng Zhou, Jing Wang & Guoquan Li

  2. Department of Nuclear Medicine, Air Force Medical Center, No. 30 Fucheng Road, Haidian District, Beijing, 100142, China

    Xinghong Ma

  3. Department of Nuclear Medicine, Sanmenxia Central Hospital, Middle of Xiaoshan Road, Hubin District, Sanmenxia, Henan, 472000, China

    Xiao Zhang

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Correspondence to Jing Wang or Guoquan Li.

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No potential conflicts of interest were disclosed.

Ethics approval and consent to participate

This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of the Air Force Medical University. The committee’s reference number was KY20232047-X-1. All procedures performed in this study were performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethics standards. Informed consent to participate was obtained from all patients included in the study.

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Xin, K., Ma, X., Meng, X. et al. Assessment of myocardial injury by SPECT myocardial perfusion imaging in patients with COVID-19 infection in a single center after lifting the restrictions in China. Ann Nucl Med 38, 971–979 (2024). https://doi.org/10.1007/s12149-024-01970-0

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