SPECT myocardial perfusion imaging identifies myocardial ischemia in patients with a history of COVID-19 without coronary artery disease

Int J Cardiovasc Imaging. 2022 Feb;38(2):447-456. doi: 10.1007/s10554-021-02477-9. Epub 2021 Nov 22.

Abstract

We aimed to examine the effect of a history of COVID-19 on myocardial ischemia in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in patients who presented with shortness of breath and/or chest pain after recovery. For this single-center retrospective study, patients who presented at cardiology outpatient clinics and had SPECT-MPI were screened. A total of 1888 patients were included in the study, 340 of whom had a history of COVID-19. 64 patients with > 50% stenosis on coronary angiography were excluded from the study. The primary outcome of the study was abnormal MPI. In the study population, the median age was 56 (49-64 IQR) years, and 1127 (65%) of the patients were female. Abnormal MPI was detected in 77 patients (23%) in the COVID-19 group and in 244 patients (16%) in the non-COVID-19 group. After adjustment was performed for clinical predictors using Bayesian logistic regression, an important association was found between the presence of a confirmed prior COVID-19 infection and abnormal MPI (posterior median odds ratio, 1.70 [95% CrI, 1.20-2.40], risk difference, 9.6% [95% CrI, 1.8%, 19.7%]). In SPECT-MPI, ischemia rates were observed to be higher in COVID-19 group and it was found that a confirmed prior COVID-19 might predict of abnormal MPI.

Keywords: COVID-19; Myocardial ischemia; Myocardial perfusion imaging; SPECT.

MeSH terms

  • Bayes Theorem
  • COVID-19* / complications
  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Female
  • Humans
  • Middle Aged
  • Myocardial Ischemia* / diagnostic imaging
  • Myocardial Perfusion Imaging* / methods
  • Predictive Value of Tests
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, Emission-Computed, Single-Photon / methods