Clinical and Histopathological Characteristics of Patients With Myocarditis After mRNA COVID-19 Vaccination
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- Omori Taku
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine Department of Histology and Cell Biology, Mie University Graduate School of Medicine
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- Maruyama Kazuaki
- Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
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- Ohta-Ogo Keiko
- Department of Pathology, National Cerebral and Cardiovascular Center
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- Hatakeyama Kinta
- Department of Pathology, National Cerebral and Cardiovascular Center
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- Ishibashi-Ueda Hatsue
- Department of Pathology, National Cerebral and Cardiovascular Center Department of Diagnostic Pathology, Hokusetsu General Hospital
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- Onoue Kenji
- Department of Cardiovascular Medicine, Nara Medical University
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- Nagai Toshiyuki
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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- Kato Seiya
- Division of Pathology, Saiseikai Fukuoka General Hospital
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- Okumura Takahiro
- Department of Cardiology, Nagoya University Graduate School of Medicine
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- Oikawa Masayoshi
- Department of Cardiovascular Medicine, Fukushima Medical University
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- Amiya Eisuke
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Yoshizawa Saeko
- Department of Surgical Pathology, Tokyo Women’s Medical University
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- Suzuki Tadaki
- Department of Pathology, National Institute of Infectious Diseases
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- Goto Hidemasa
- Department of Histology and Cell Biology, Mie University Graduate School of Medicine
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- Nakamura Kazufumi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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- Fujino Takeo
- Department of Advanced Cardiopulmonary Failure, Faculty of Medical Sciences, Kyushu University
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- Moriwaki Keishi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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- Nakamori Shiro
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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- Anzai Toshihisa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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- Sakata Yasushi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
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- Hiroe Michiaki
- Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine Department of Cardiology, National Center for Global Health and Medicine
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- Imanaka-Yoshida Kyoko
- Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
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- Dohi Kaoru
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
Description
<p>Background: The effects of myocarditis after mRNA COVID-19 vaccination (mCV) on myocardial tissue, and the association between cardiomyocyte injury and clinical presentation, are not fully understood.</p><p>Methods and Results: We retrospectively registered patients clinically diagnosed with myocarditis after the first or second mCV who underwent endomyocardial biopsy or autopsy from 42 participating centers in Japan. We investigated the histological features and their association with clinical presentation based on cardiomyocyte injury. Forty patients who underwent endomyocardial biopsy were included in the study. Of these, 19 (47.5%) showed mild lymphocytic infiltration and interstitial edema without cardiomyocyte injury. The remaining 21 (52.5%) patients showed cardiomyocyte injury accompanied by infiltrating inflammatory cells: 11 with lymphocytic infiltration, 7 with eosinophilic infiltration, and 3 with myocarditis with both lymphocyte and eosinophil infiltration. Compared with patients without cardiomyocyte injury, those with cardiomyocyte injury were clinically characterized by older age, a balanced sex distribution, less frequent chest pain, and a lower left ventricular ejection fraction. Fifteen of 21 (71.4%) patients with cardiomyocyte injury developed fulminant myocarditis, with 13 (86.7%) requiring mechanical circulatory support; in contrast, none of those without cardiomyocyte injury developed fulminant myocarditis (P<0.001).</p><p>Conclusions: Our histological examination of patients with myocarditis after mCV revealed varying degrees of cardiomyocyte injury, ranging from pronounced to absent, along with various types of myocarditis. Cardiomyocyte injury was strongly associated with the severity of myocarditis.</p>
Journal
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- Circulation Journal
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Circulation Journal 89 (1), 120-129, 2024-12-25
The Japanese Circulation Society