In a letter published in the December issue of the American Heart Association's medical journal Circulation a group of researchers at Vanderbilt University Medical Center (VUMC) dispute the most recent findings of the incidence of myocarditis in athletes with a history of COVID-19.
The Vanderbilt study, COVID-19 Myocardial Pathology Evaluation in AthleTEs with Cardiac Magnetic Resonance (COMPETE CMR), found a much lower degree of myocarditis in athletes than what was previously reported in other studies.
"The differences in the findings are extremely important. The whole world paused after seeing the alarmingly high rates of myocardial inflammation and edema initially published," said Dan Clark, MD, MPH, first author of the report, instructor of Cardiovascular Medicine, and a adult congenital heart disease fellow. "Our study evaluated 59 Vanderbilt University athletes and compared them to a healthy control group as well as a group of 60 athletic controls.
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"The degree of myocarditis found by cardiac MRI in Vanderbilt athletes was only 3%, which is really good news," said Clark. "Since our first evaluation, we have screened almost double that number and the same findings are holding true.
"But there was also a piece of disappointing news," he said. "None of the other screening tests helped us to identify the athletes with myocarditis, and none of those athletes had experienced symptoms of COVID.
"Initially, we hoped that the standard screening tests for athletes would be definitive because we wanted something that was widely available and quick," said Clark. "We hoped that a cardiac MRI would only be used if absolutely necessary.
"However, their blood work, clinical exams, EKG, echocardiograms and other cardiovascular screening were normal. All of those traditional screening results would have led us to agree to allow some athletes to participate in a sporting event or practice, while the MRI told a different story."
Myocarditis is a disorder of abnormal inflammation of the heart muscle and is a leading cause of sudden cardiac death among athletes. The findings highlight the importance of considering cardiac MRI in addition to traditional screening measures to detect myocarditis.
It is well documented that COVID-19 may affect the heart.
"Our data also demonstrated more scarring in healthy heart muscle than we would have thought," Clark said.
Those findings led the group to dig deeper and compare a healthy, athletic population with normal cardiac MRI values against those who had recovered from COVID.