Ohio State Cardiologist Says Cardiac MRI Can Help Doctors Feel Safe – Athletes Return After COVID-19

               Links between COVID-19 and heart issues, particularly myocarditis, were one of the reasons the Big Ten decided to postpone the game on 11 August.                 </p><div><p>

Can the Big Ten vote in favor of playing football this week, depending on whether the conference is confident it can mitigate those risks.

The Big Ten may be one way to do this: using cardiac MRI to detect possible cases of myocarditis in athletes who test positive for COVID-19.

Between the Big Ten and the nationwide debate over the risks of playing sports during the COVID-19 pandemic, a group of Ohio State doctors and researchers conducted a study using cardiac MRI.  CMR - To detect symptoms associated with myocarditis in college athletes who tested positive for the virus.

One of the findings of that study, which was published on Friday: "While large studies, including long-term follow-up and control populations, are needed to understand CMR changes in competitive populations, CMR is an excellent tool for myarditis in athletes. Can provide risk-stratification assessment. Those who have overcome COVID-19 to direct safe competitive sports participation. "

"The focus of our study was to see if we could do a test that could allow those athletes to resume the sport, so that the doctors who were watching these athletes would send them back to competitive sports Feel safe about  And if you rule out myocarditis by MRI, sports cardiologists will feel safe about sending these athletes back into action, ”said Ohio State Cardiologist Saurabh Rajpal, the study's lead author.

The Ohio State study tested 26 competitive college athletes, and four of them found inflammation of the heart muscle indicating possible myocarditis.  Late gadolinium growth was found in eight other athletes, which Rajpal said could be a sign of a virus-like heart injury, but could also indicate an athlete's heart adaptation depending on how vigorously they exercised.

Because the study involved only 26 athletes, Rajpal stated that the data were not sufficient to draw any statistically significant conclusions about how high the risk of myocarditis associated with COVID-19 is.  He also did not want sports to be played during the epidemic.  At Ohio State, however, cardiac MRI is used to return athletes to practice, in addition to the specific tests team doctors will conduct on athletes after they become ill.

"When we started studying, our goal was to find something that we could feel safe about sending these athletes back," said Rajpal. <em>Eleven warriors</em>.  “In addition to performing the normal test, in our opinion an MRI was to be done.  So if you do an MRI, and the heart does not show myocarditis, at OSU we are letting athletes return to practice.  We are letting them return to normal intensity of exercise if their MRI was negative.  "

The risk of myocarditis - inflammation of the heart muscle - should be taken seriously by team doctors as it has been identified as the cause of sudden cardiac death in athletes.  If the condition of an athlete is very bad and he starts taking action soon, serious consequences can occur.

Myocarditis is not a new phenomenon, however, and it can also be caused by other viruses;  Due to how widespread the COVID-19 epidemic is, it is now receiving more attention.

Rajpal said, "If someone has a heart swelling, and he or she remains at a high level of exercise, then there is a risk of abnormal heart rhythm, and this can sometimes lead to death."  "These are rare examples, I point out, and myocarditis is very uncommon in itself. It's not a common disease. But because viral infections have affected so many people, we're talking more about it . "

The lead physician of the Ohio State football team, James Borers, co-authored the study with Rajpal.  He is now returning to the Competition Task Force to serve as co-chairman of the Medical Subcommittee of the Big Ten, whose withdrawal plan was positively received on Saturday by a Steering Committee of eight Big Ten presidents and chancellor Was, which could go ahead as of Sunday, a vote to play on this fall.  When he was asked about myocarditis by Ohio Village Mike Myvin during Devin's briefing on August 18, he indicated that it was something doctors "need to be aware of", but also that they "need not be overly afraid" is".  "
Aaron Bagish, director of the cardiac performance program at Massachusetts General Hospital, said during a broadcast on Friday <a target="_blank" href="https://twitter.com/i/broadcasts/1ZkKzmNjMpWxv" rel="noopener noreferrer">Official social media account of NCAA</a> He believes that concerns about myocarditis should be a reason for not playing college sports, assuming the proper protocol can identify athletes who develop cardiovascular symptoms and fully recover from them. Keep out of action until it happens.

"The algorithm we have in place, I believe, is going to identify high-risk athletes who should be banned, and an individual decision between team physicians, sports cardiologists, and athletes" Bugish said.  "The decision to play football or other collegiate sports right now is very much, in my opinion, about the ability to transmit this virus as a public health issue rather than a cardiology issue."

According to Ohio State research, Rajpal says the next step will involve performing a cardiac MRI on athletes who have not tested positive for COVID-19 to compare their results against those who have not.  They will also perform follow-up scans on athletes who have shown symptoms of myocarditis to see how they heal, while they also plan to test for blood markers to see if they can identify any indicators associated with myocarditis .

Ultimately, Ohio State's research may allow them to draw more conclusions about how high the risk of developing myocarditis as a result of COVID-19 infection and whether there are other factors that lead one to terminate COVID-19 Are likely to do.  With issues related to the heart, but they are not there yet.

"I think there have been many studies that have shown that the heart can be affected as a result of this infection. We just have to get more data and do more research to determine how to identify that population Which affects the heart, "Rajpal said." And then go ahead and figure out what the next step will be to reduce the danger, and move on from there. "