Abstract 14282: Electrocardiography Rules out Myocardial Abnormalities on Cardiac Magnetic Resonance Imaging in Post-Hospitalized COVID-19 Patients: A Multicenter Observational Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2023-11, Vol.148 (Suppl_1)
• Main Authors: Abd Samat, Azlan Helmy, Mahmod, Masliza, Lewandowski, Adam J, Cassar, Mark Philip, Akhtar, Mohammed, Moss, Alastair, Manisty, Charlotte, Treibel, Thomas, Ashkir, Zakariye, McCracken, Celeste, Lukaschuk, Elena, Piechnik, Stefan, Ferreira, Vanessa, Xie, Cheng, Cuthbertson, Dan, Kemp, Graham, Nikolaidou, Chrysovalantou, Miller, Christopher, Chiribiri, Amedeo, O'Regan, Declan, Francis, Susan, Steeds, Richard P, Weir-McCall, Jonathan, Wild, Jim M, Plein, Sven, McCann, Gerry, Evans, Rachael, brightling, chris, Neubauer, Stefan, Raman, Betty
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.148.suppl_1.14282

Abstract only Introduction: The diagnostic performance of EKG in ruling out myocardial abnormalities following COVID-19 is unclear. Aim: To assess the ability of EKG to exclude cardiac abnormalities on cardiac magnetic resonance imaging (CMR) in post-hospitalised COVID-19 patients. Methods: Post-hospitalized patients (n=212) & comorbidities matched controls (n=38) underwent CMR and 12-lead EKG. EKG assessments included depolarization & repolarization abnormalities [ QTc , corrected QT dispersion ( QTc disp ), JT ( JTc ) & T peak-end ( cTPe ) intervals]. CMR abnormalities were defined as reduced left ventricular ejection fraction (LVEF), high T1 & T2 Z scores and high extracellular volume and pathological late gadolinium enhancement. Results: At 5.6 months post-discharge, patients had a higher burden of EKG abnormalities vs controls (72.2% vs 42.1%, p=0.001 ) (Figure A) . CMR abnormalities were comparable despite patients having lower LVEF. Abnormal EKG findings and prolonged repolarization were more common in patients with CMR abnormalities vs patients with normal CMR and controls ( Figure A & B ). Area-under-the-receiver-operating curve (AUROC) of routine EKG abnormalities to discriminate abnormal CMR was 0.56 (95% CI 0.47-0.65), p=0.185. Inclusion of JTc & QTc disp improved the AUROC to 0.64 (95% CI 0.55-0.74), p=0.002. Inclusion of JTc ≥340ms & QTc disp ≥40ms improved the sensitivity from 81.6% to 99.9% with higher negative predictive value (84.7% to 99.9%) ( Figure A ). Conclusions: Post-hospitalized COVID-19 patients have more EKG abnormalities than comorbidities-matched controls. A normal EKG with normal repolarization is effective in ruling out significant CMR abnormalities.