MRI shows lower degrees of myocarditis in athletes who have recovered from COVID-19

In a letter appearing in the December issue of Circulation, Vanderbilt University Medical Center researchers question recent findings of the incidence of myocarditis in athletes with a history of COVID-19. The study, known as COMPETE CMR, found a much lower degree of myocarditis in athletes vs. previous studies. The group assessed 59 Vanderbilt University athletes and compared them to a healthy control group as well as a group of 60 athletic controls. "The degree of myocarditis found by cardiac MRI in Vanderbilt athletes was only 3%, which is really good news," said Dan Clark, first author of the report and an instructor of cardiovascular medicine. "Since our first evaluation, we have screened almost double that number and the same findings are holding true.” The team found that the athletic control group without COVID showed 24% scarring in the heart muscle while the COVID athlete group had a 27% scarring ratio. Clark explained that athletes commonly have a small area of benign scar due to athletic remodeling. "This particular piece of information is very important to share - myocarditis after COVID-19 tends to be in a similar spot," he said. "Without the knowledge that this area of scarring is common in healthy athletes, clinicians could attribute the scarring to consequences from COVID-19. Those assumptions might unnecessarily restrict some athletes from competition." Clark also noted that the addition of cardiac MRI as an assessment tool for athletes may prove helpful in determining safe return-to-play guidelines.

Nanodroplets, ultrasound drills show promise with blood clots

Experts have developed a technique, which has demonstrated promise in in vitro testing, for eliminating particularly tough blood clots with engineered nanodroplets and an ultrasound drill. The nanodroplets consist of tiny lipid spheres filled with liquid perfluorocarbons (PFCs). These nanodroplets are filled with low-boiling-point PFCs, and as they convert into a gas, they expand rapidly, vaporizing the nanodroplets and forming microscopic bubbles. "We introduce nanodroplets to the site of the clot, and because the nanodroplets are so small, they are able to penetrate and convert to microbubbles within the clots when they are exposed to ultrasound," explained Leela Goel, first author of a paper on the work who is a PhD student in the joint biomedical engineering department at North Carolina State University and the University of North Carolina at Chapel Hill. The continued exposure of the clots to ultrasound oscillates the microbubbles, with their rapid vibration making them behave like tiny jackhammers, disrupting the clot's physical structure, and helping to dissolve the clots. This vibration also creates larger holes in the clot mass, permitting anticlotting drugs to penetrate deep into the clot and further break it down. The technique is done via ultrasound transducer that is small enough to be introduced to the blood vessel through a catheter. The paper appeared Jan. 6, 2021, in the journal Microsystems & Nanoengineering.

Common blood pressure meds safe for those with COVID-19

High blood pressure medications do not have an impact on outcomes in those hospitalized with COVID-19. That’s according to researchers at the Perelman School of Medicine at the University of Pennsylvania. The study, published Jan. 7, 2021, in The Lancet Respiratory Medicine, is the first randomized, controlled trial to show there is no risk for patients continuing these medications while hospitalized for COVID-19, the researchers assert. Specifically, investigators examined whether ACE inhibitors (ACEIs) or angiotensin receptor blockers could help mitigate complications or lead to more severe symptoms. To arrive at this conclusion, the researchers assessed 152 participants in several countries between March 31 and Aug. 20, 2020, who were in the hospital with COVID-19 and already using one of the medications. The participants were assigned to either stop or continue taking their prescribed medication and closely monitored to evaluate the effect of temporarily stopping the therapy. “Observational studies were rapidly done, but randomized trials are important to establish a definitive answer regarding the potential impact of these commonly used blood pressure medications in the setting of COVID-19," said study corresponding and senior author Julio Chirinos, an associate professor of Cardiovascular Medicine in the Perelman School of Medicine. "Our trial results importantly show that these medications can be safely continued for patients hospitalized with COVID-19."