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Cardiac Imaging

Cardiovascular Magnetic Resonance Findings in Competitive Athletes Recovering From COVID-19 Infection

Educational Objective
To understand the latest cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19

1 Credit CME

JAMA Cardiology

Published Online: September 11, 2020

Research Letter

Article Information and Disclosures

Saurabh Rajpal, MBBS, MD¹;

Matthew S. Tong, DO¹;

James Borchers, MD, MPH¹;

Karolina M. Zareba, MD¹;

Timothy P. Obarski, DO¹;

Orlando P. Simonetti, PhD¹;

Curt J. Daniels, MD¹

Author Affiliations

¹The Ohio State University, Columbus

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Myocarditis is a significant cause of sudden cardiac death in competitive athletes and can occur with normal ventricular function.¹ Recent studies have raised concerns of myocardial inflammation after recovery from coronavirus disease 2019 (COVID-19), even in asymptomatic or mildly symptomatic patients.² Our objective was to investigate the use of cardiac magnetic resonance (CMR) imaging in competitive athletes recovered from COVID-19 to detect myocardial inflammation that would identify high-risk athletes for return to competitive play.

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Article Information

Corresponding Author: Saurabh Rajpal, MBBS, MD, Division of Cardiology, The Ohio State University, 473 W 12th Ave, Columbus, OH 43210 (saurabh.rajpal@osumc.edu).

Accepted for Publication: August 25, 2020.

Published Online: September 11, 2020. doi:10.1001/jamacardio.2020.4916

Author Contributions: Drs Rajpal and Daniels had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Rajpal, Tong, Borchers, Obarski, Simonetti, Daniels.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Rajpal, Tong, Simonetti.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Rajpal, Tong, Obarski.

Administrative, technical, or material support: Rajpal, Tong, Zareba, Simonetti, Daniels.

Supervision: Rajpal, Tong, Borchers, Daniels.

Conflict of Interest Disclosures: Dr Simonetti reports grants from Siemens, Myocardial Solutions, and Cook Medical outside the submitted work. No other disclosures were reported.

References

Maron BJ , Udelson JE , Bonow RO , et al; American Heart Association Electrocardiography and Arrhythmias Committee of Council on Clinical Cardiology, Council on Cardiovascular Disease in Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and American College of Cardiology. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132(22):e273-e280.PubMed Google Scholar

Puntmann VO , Carerj ML , Wieters I , et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557 PubMed Google Scholar

Messroghli DR , Moon JC , Ferreira VM , et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). [published correction appears in J Cardiovasc Magn Reson. 2018;20(1):9]. J Cardiovasc Magn Reson. 2017;19(1):75. doi:10.1186/s12968-017-0389-8 PubMed Google Scholar Crossref

Ferreira VM , Schulz-Menger J , Holmvang G , et al. Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations. J Am Coll Cardiol. 2018;72(24):3158-3176. doi:10.1016/j.jacc.2018.09.072 PubMed Google Scholar Crossref

Phelan D , Kim JH , Chung EH . A game plan for the resumption of sport and exercise after coronavirus disease 2019 (COVID-19) infection. JAMA Cardiol. 2020. doi:10.1001/jamacardio.2020.2136 PubMed Google Scholar

Gräni C , Eichhorn C , Bière L , et al. Prognostic value of cardiac magnetic resonance tissue characterization in risk stratifying patients with suspected myocarditis. [published correction appears in J Am Coll Cardiol. 2017;70(21):2736]. J Am Coll Cardiol. 2017;70(16):1964-1976. doi:10.1016/j.jacc.2017.08.050 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.