Utility of 99mTc-MIBI myocardial perfusion imaging in the evaluation of cardiovascular complications in COVID-19 patients

Abstract

The coronavirus disease is due to Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2). COVID-19 mainly affects the respiratory and immune systems and other organs like the cardiovascular and nervous systems, lungs, and kidneys (1). Several studies have reported COVID-19 patients with persistent symptoms for months after the initial phase. The most common symptoms are fatigue, headaches, cough, anosmia, arthralgia, and chest pain (2). Studies have shown this modality to diagnose, follow up, and evaluate response to treatment in chronic COVID-19 complications using 99mTc-MIBI myocardial perfusion single photon emission computed tomography (SPECT), pulmonary involvement with  99mTc-MAA perfusion lung scan, renal involvement with 99mTc-DTPA, and 99mTc-DMSA renal scintigraphy (3). Myocardial perfusion imaging with 99mTc-MIBI provides meaningful data to predict prognosis, risk of annual cardiac events, and evaluation of myocardium viability (4). Conventional SPECT Myocardial Perfusion Imaging (MPI) needs a viable metabolically active myocardial cell to extract the radiotracer. A review of articles shows that 99mTc-MIBI myocardial perfusion scintigraphy could be helpful in the timely acute myocardial infarction (MI) diagnosis and myocardial viability in COVID-19 patients. It is also beneficial in managing COVID-19 patients with heart failure by myocardial injury evaluation and choosing the best therapeutic choice, prognosis, and treatment response.