Ohio State discovers new way to identify heart inflammation in athletes with COVID – The Columbus Dispatch

Protocols recommend a clinical examination, an ultrasound, an electrocardiogram and a blood test to help diagnose myocarditis in athletes who contracted the coronavirus. The Ohio State study used all of methods as well as CMR imaging, which was found to be successful in spotting myocardial inflammation that was not picked up by the other methods.

A new Ohio State study shows a cardiac MRI can identify myocarditis, or inflammation of the heart muscle, in athletes.

The test could help determine when athletes diagnosed with COVID-19 can safely return to playing sports, the university said.

Researchers at Ohio State’s Wexner Medical Center examined 26 male and female college athletes from across the Midwest who tested positive for COVID-19, looking for signs of myocarditis, a rare disease that can cause heart failure and sudden cardiac death.

Existing protocols recommend a clinical examination, an ultrasound, an electrocardiogram and a blood test to help diagnose myocarditis in athletes before they are allowed to return to competitive play.

The Ohio State researchers used all of those methods and added cardiac magnetic resonance (CMR) imaging, which was found to be successful in spotting myocardial inflammation that was not picked up by the other methods.

CMR imaging shows detailed images of the heart. It can help doctors study the heart muscle’s structure and find the cause of a patient’s heart failure or spot tissue damage.

Using CMR imaging, 15% of athletes in the study were shown to possibly have myocarditis. Eight other athletes had scar tissue which could either be prior myocardial injury or normal athletic adaptation of the heart.

“We were able to differentiate those who had evidence of myocardial inflammation — and therefore myocarditis — from those who did not, and the MRI became the tool that did that with the highest sensitivity,” said Dr. Curt Daniels, co-author of the study, a cardiologist and professor at Ohio State Wexner Medical Center.

Myocarditis causes about 75 deaths per year in young athletes between the ages of 13 and 25, usually without warning, according to the Myocarditis Foundation. It is typically caused by a viral infection that occurs in young adults, and often affects males more than females.

Myocarditis has been seen in patients who have recovered from COVID-19. Twelve athletes studied by the Ohio State researchers reported mild symptoms of COVID-19 and the rest were asymptomatic.

“Anytime there is inflammation in the heart, we have to recommend rest for three months,” said Dr. Saurabh Rajpal, a cardiologist and an assistant professor in Ohio State’s Division of Cardiovascular Medicine at the College of Medicine, who led the study.

The researchers wouldn’t specify how many athletes were from Ohio State or provide a breakdown of the sports they played.

Rapid result testing and CMR imaging can provide increased safety for athletes returning to play.

“Anytime you feel as though you can provide increased safety, you feel more comfortable with participating,” Daniels said. “Combining those two things would appear at least where we are today. We may be talking something different six months from now, but where we are today in the current environment and current data, these would be two tools to potentially provide a safe environment to get back to playing.”

Doctors are worried about athletes who have recovered from COVID-19 having heart issues.

The Big Ten Conference canceled the fall sports season on Aug. 11 because of fears about player safety related to COVID-19. Several other conferences have followed suit.

Myocarditis has been seen in at least five Big Ten Conference athletes, according to ESPN.

Boston Red Sox pitcher Eduardo Rodriguez is out for the rest of the season after developing myocarditis following a positive COVID-19 test before Boston’s summer camp.

Myocarditis is not limited to just athletes. A July study showed that of 100 adult patients in Germany who had recovered from COVID-19, 60 had ongoing myocardial inflammation.

The Ohio State research was published online in JAMA Cardiology.

Dispatch reporter Bill Rabinowitz contributed to this report.

mhenry@dispatch.com

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