HYPERTENSION: A KEY FACTOR CONTRIBUTING TO MYOCARDIAL EDEMA IN POST-COVID PATIENTS REVEALED BY CARDIAC MRI

Objective: Hypertension pressure (BP), is a major risk factor for cardiovascular disease (CVD) and is widely prevalent in the global population. It is strongly associated with the development of various cardiovascular conditions and it often leads to long-term cardiovascular damage, significantly increasing the risk of morbidity and mortality. In the context of SARS-CoV-2 infection, there has been a notable rise in the occurrence of myocarditis during the post-COVID period. Cardiac magnetic resonance imaging (CMR) emerging as a key diagnostic tool for diagnosos of myocarditis and offers unique insights into the inflammatory process, enabling non-invasive detection of myocardial damage and influencing patient management and prognosis. The connection between hypertension and post-COVID myocarditis is becoming increasingly evident, as elevated blood pressure may contribute to the progression and severity of viral myocarditis in COVID-19 patients, further highlighting the critical role of blood pressure control in this context. Design and method: Fifty-one patients who underwent cardiac magnetic resonance (CMR) imaging for myocarditis were divided into two groups based on the presence of myocardial edema (ME): Group 1, consisting of 31 patients with ME, and Group 2, comprising 20 patients without ME. The collected data included demographic information as well as cardiovascular risk factors, such as smoking status, obesity, diabetes mellitus, hyperlipidemia, heart failure, and blood pressure (BP). Results: Compared to ME-naive patients, those with ME were older (50.48±16.76 vs. 41.47±15.91; p = 0.05) and more often males. There were no statistically significant differences between the study groups regarding presence of type 2 diabetes (45.7% vs. 56.1%), hypercholesterolemia (56.7% vs. 54.1%) and obesity (66.5% vs. 61.2%), all p>0.05. However, patients with ME presented more frequently BP (69.9% vs. 48.9%; p=0.003), heart failure (64.5% vs. 44.7%; p=0.002) and smoking habits (89.9% vs. 31.8%; p<0.001). Conclusions: Our data indicate that in post-COVID patients, ME observed on CMR is strongly associated with several cardiovascular risk factors, particularly BP, along with heart failure and smoking status. These findings highlight the potential role of BP in influencing the progression of viral myocarditis in COVID patients.