Cardiovascular Imaging Evaluating Possible Association Between COVID-19 Vaccines and Myocarditis Published in Journal of American College of Cardiology: Imaging

MHIF Leveraging Expertise in Imaging to Evaluate Clinical Evidence

MINNEAPOLIS – June 16, 2021 The Minneapolis Heart Institute Foundation® (MHIF) announced today the publication of clinical and cardiac magnetic resonance (CMR) imaging findings of acute myocarditis temporally related to mRNA COVID-19 vaccination in four patients (2 women, 2 men, ages 16-31). This research adds to recent observations regarding a possible immunological link between acute myocarditis and COVID-19 vaccination in some young adults. This research is important as the clinical knowledge about COVID-19 vaccines continues to grow. The results were published online this week in the Journal of the American College of Cardiology: Cardiovascular Imaging.

“With advances in cardiac imaging, we are compelled to do this research and add to the clinical evidence available to evaluate this possible association of COVID-19 mRNA vaccinations and acute myocarditis,” said Mario Gössl, MD, cardiologist and researcher at MHIF, and principal investigator in the research study that was designed and led by a team of MHIF physicians. “There is a trend of seeing this in younger adults/adolescents and in patients who had prior COVID-19 infection or high risk-exposures. While this case series adds additional insights to consider, this does not prove a direct cause and warrants ongoing research and monitoring in a larger population.”

The research reports CMR imaging findings in four cases of acute myocarditis using a unique institutional imaging protocol implemented at Abbott Northwestern Hospital by João Cavalcante, MD, MHIF researcher, director of the CMR lab and co-author of the manuscript. The imaging protocol uses a combination of parametric T1, T2 and extracellular (ECV) mapping along with traditional late-gadolinium imaging to identify myocardial edema and non-ischemic injury, both of which support acute myocarditis as per updated Lake Louise criteria (LLC). LLC provides established diagnostic imaging criteria and uses tissue-based CMR markers to identify the presence of myocarditis.

This is the largest case series of adolescents and young adults published to date and highlights the use of CMR imaging in the evaluation of acute myocarditis in the setting of recent COVID-19 vaccination. Notably, two patients with prior COVID-19 infection developed symptoms following their first dose, and the two patients without prior COVID-19 infection developed symptoms following their second dose, raising questions about a potential immune-boosting mechanism after prior immune exposure or priming that warrants further research.

“This is another example of the importance of ongoing research as we continue to learn from and manage the impact of the COVID-19 pandemic on all areas of health, including cardiovascular,” said Dr. Gössl. “This research isn’t a definitive answer, but it adds to the clinical insights available and encourages ongoing study and diligent monitoring.”


About Minneapolis Heart Institute Foundation®

The Minneapolis Heart Institute Foundation (MHIF) strives to create a world without heart and vascular disease. To achieve this bold vision, it is dedicated to improving the cardiovascular health of individuals and communities through innovative research and education.

Scientific Innovation and Research – MHIF is a recognized leader across all specialties of heart and vascular research. Each year, MHIF leads more than 200 research studies with more than 2,200 patients and publishes more than 200 articles to share learnings from research. MHIF research has improved the standard of care around the world through protocols like Level One for heart attack, which significantly improved outcomes and survival for patients.

Education and Outreach – MHIF provides more than 10,000 hours of education each year putting its research into practice to improve outcomes among health care providers. This commitment extends to patients and caregivers through a number of community health and education events to raise awareness of heart care and research, engaging individuals in their own health.

The Minneapolis Heart Institute Foundation’s work is funded by generous donors and sponsors and engages in cutting-edge research initiatives with its physician partners from the Minneapolis Heart Institute® at Abbott Northwestern Hospital and at 38 community sites across Minnesota and western Wisconsin. For more information, please visit

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Cardiac magnetic resonance (CMR) imaging showing acute myocarditis temporally related to the receipt of mRNA COVID-19 vaccination in four cases (16-31 years) raises the interesting possibility about a potential immune-boosting mechanism after prior immune exposure or priming (Figure).