by Zachary Stieber, The Liberty Daily:

Heart scarring was detected more than one year after COVID-19 vaccination in some people who suffered myocarditis following receipt of a shot, researchers reported in new studies.

A third of 60 patients with follow-up cardiac imaging done more than 12 months after their myocarditis diagnosis had persistent late gadolinium enhancement (LGE), which is, in the majority of cases, reflective of heart scarring, Australian researchers reported in a preprint of a new study, published on March 22.

Myocarditis is a form of heart inflammation.

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The median time from receipt of a vaccine to follow-up imaging was 548 days, with the longest interval being 603 days.

“We found that the incidence of persistent myocardial fibrosis is high, seen in almost a third of patients at >12 months post diagnosis, which could have implications for the management and prognosis of this predominantly young cohort,” the researchers wrote.

“The long-term clinical implications of LGE in this condition are as yet unknown, but LGE has been demonstrated to confer worse prognosis in non-COVID-19 vaccine-associated myocarditis, especially if it persists beyond six months,” they added later, pointing to several previous papers.

Researchers in one of the previous papers, for instance, found that LGE was a “powerful prognosticator” of adverse outcomes in myocarditis patients.

Before the new testing, nine patients were determined to definitely have myocarditis, and 58 patients were labeled as probably having myocarditis. The findings of persistent LGE resulted in reclassifying 16 of the cases from probable myocarditis to definite myocarditis.

Exclusions included patients who were pregnant or allergic to agents used in gadolinium testing.

Among a subset of 20 patients who underwent imaging shortly after vaccination, 19 had LGE. In follow-up imaging, LGE was no longer visible in 10 of those patients. In five, it was reduced, but in four it was unchanged.

Andrew Taylor, a professor at Monash University’s Central Clinical School, and his co-authors conducted the study by recruiting patients who were diagnosed with myocarditis associated with COVID-19 vaccination between August 2021 and March 2022. The patients were invited to undergo imaging at Alfred Hospital or Royal Children’s Hospital in Melbourne, Australia.

The study population with follow-up imaging included 44 adults and 16 adolescents.

Most of the patients had received a Pfizer-BioNTech shot. A minority had received a Moderna or AstraZeneca vaccination. The companies did not respond to requests for comment.

Limitations of the paper, which was published ahead of peer review, included possible selection bias, since participation in the study was voluntary. Authors listed no conflicts of interest or funding.

Another Paper

In the other recent paper, researchers in Canada reported finding about half of patients referred for imaging due to possible post-vaccination myocarditis had persistent LGE in follow-up imaging.
Overall, 60 patients were included in the retrospective study. Of those, seven reported persistent symptoms.

In a subset of 21 patients for whom follow-up MRIs were available, 10 had persistent LGE, the researchers said. On the other hand, function of the left ventricle, which pumps blood, had normalized in all patients.

The persistent LGE “likely reflects replacement fibrosis,” or heart scarring, Dr. Kate Hanneman, with the University of Toronto’s Department of Medical Imaging, and her co-authors wrote. They cited some of the same papers as the Australian group, including the study that found patients with persistent LGE had a higher risk of adverse outcomes, as well as a paper on what it represents when LGE is found on MRI in patients with myocarditis.

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