Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6784
Peer-review started: March 23, 2022
First decision: May 12, 2022
Revised: May 16, 2022
Accepted: June 17, 2022
Article in press: June 17, 2022
Published online: July 16, 2022
Processing time: 103 Days and 15 Hours
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In some patients, COVID-19 is complicated with myocarditis. Early detection of myocardial injury and timely intervention can significantly improve the clinical outcomes of COVID-19 patients. Although endomyocardial biopsy (EMB) is currently recognized as the ‘gold standard’ for the diagnosis of myocarditis, there are large sampling errors, many complications and a lack of unified diagnostic criteria. In addition, the clinical methods of treating acute and chronic COVID-19-related myocarditis are different. Cardiac magnetic resonance (CMR) can evaluate the morphology of the heart, left and right ventricular functions, myocardial perfusion, capillary leakage and myocardial interstitial fibrosis to provide a noninvasive and radiation-free diagnostic basis for the clinical detection, efficacy and risk assessment, and follow-up observation of COVID-19-related myocarditis. However, for the diagnosis of COVID-19-related myocarditis, the Lake Louise Consensus Criteria may not be fully applicable. COVID-19-related myocarditis is different from myocarditis related to other viral infections in terms of signal intensity and lesion location as assessed by CMR, which is used to visualize myocardial damage, locate lesions and quantify pathological changes based on various sequences. Therefore, the standardized application of CMR to timely and accurately evaluate heart injury in COVID-19-related myocarditis and develop rational treatment strategies could be quite effective in improving the prognosis of patients and preventing potential late-onset effects in convalescent patients with COVID-19.
Core tip: This review aims to explore the frontiers of Coronavirus disease 2019 (COVID-19)-related myocarditis as assessed by Cardiac magnetic resonance (CMR) and compare the similarities and differences in CMR signs between COVID-19-related myocarditis and myocarditis related to other viral infections. COVID-19-related myocarditis is different from myocarditis related to other viral infections in SI and lesion location as assessed by CMR. The Lake Louise Consensus Criteria are not fully applicable to COVID-19-related myocarditis. CMR is expected to visualize myocardial damage, locate lesions and quantify pathological changes based on various sequences with the benefit of staged diagnosis and treatment in COVID-19-related myocarditis.