Objective: This study aimed to investigate the late-term effects of the BNT162b2 mRNA COVID-19 vaccine on myocardial perfusion using myocardial perfusion scintigraphy (MPS). Materials and Methods: A retrospective analysis was conducted on 181 procedures involving pharmacological stress and rest single-photon emission computed tomography (SPECT) MPS performed between September 2020 and September 2023 in participants aged 18–70 years. Participants were divided into two groups: those who received the BNT162b2 mRNA vaccine (n=93) and those who did not (n=88). Individuals with prior cardiac surgery, severe valvular disease, atrial fibrillation, or other significant comorbidities affecting myocardial function were excluded. Demographic data, cardiovascular risk factors, and MPS parameters (end-diastolic volume [EDV], end-systolic volume [ESV], ejection fraction [EF], summed stress score [SSS]) were compared between groups. Results: No significant intergroup differences were observed in age, sex, or cardiovascular risk factors (p > 0.05). The mean SSS was 2.54 ± 3.69 in vaccinated and 2.78 ± 4.15 in unvaccinated individuals (p = 0.453). Mean EF values between the vaccinated and unvaccinated groups were 64.27 ± 7.85% compared to 62.16 ± 9.79% (p = 0.11). No significant differences were observed in EDV (74.91 ± 18.63 ml vs. 77.18 ± 23.66 ml; p = 0.48) and ESV (27.58 ± 11.24 ml vs. 30.65 ± 15.69 ml; p = 0.14). No statistically significant difference was found in the frequency of ischemic MPS findings between the vaccinated and unvaccinated groups (34% vs. 35%; p = 0.89). Conclusion: No adverse effects of the BNT162b2 mRNA vaccine on late-term myocardial perfusion or left ventricular function were detected.
Cite this Article As :
Erol M, Sen AE. Evaluation of Late-Term Effects of BNT162b2 mRNA COVID-19 Vaccine on Myocardial Perfusion by Myocardial Perfusion Scintigraphy.
Selcuk Med J 2026;42(2): 113-118
1. World Health Organization. Coronavirus Disease 2019 (Covid-19) Situation Report-51. 2020. Available from: https://www.who.int/docs/default-source/coronaviruse /situation-reports/20200311-sitrep-51-Covid-19.pdf. Accessed 28 Jan 2021.
2. Gargano JW, Wallace M, Hadler SC, et al. Use of mRNA Covid-19 vaccine after reports of myocarditis among vaccine recipients: update from the advisory committee on immunization practices — United States, June 2021. MMWR Morb Mortal Wkly Rep. 2021;70(27):977-82. doi: 10.15585/mmwr.mm7027e2
3. Dickey JB, Albert E, Badr M, et al. A series of patients with myocarditis following SARS-CoV-2 vaccination with mRNA-1279 and BNT162b2. JACC Cardiovasc Imaging. 2021;14(8):1862-63. doi: 10.1016/j.jcmg.2021.06.003
4. Shaw KE, Cavalcante JL, Han BK, et al. Possible association between Covid-19 vaccine and myocarditis: clinical and CMR findings. JACC Cardiovasc Imaging. 2021;14(9):1856-61. doi: 10.1016/j.jcmg.2021.06.002
5. Correction: Reports of myocarditis and pericarditis following mRNA Covid-19 vaccination: a systematic review of spontaneously reported data from the UK, Europe and the USA and of the scientific literature. BMJ Open. 2022;12(7):e059223corr1. doi: 10.1136/bmjopen-2021-059223corr1
6. Kaur RJ, Dutta S, Charan J, et al. Cardiovascular adverse events reported from Covid-19 vaccines: a study based on WHO database. Int J Gen Med. 2021;14:3909-27. doi: 10.2147/IJGM.S324349
7. Simone A, Herald J, Chen A, et al. Acute myocarditis following Covid‐19 mRNA vaccination in adults aged 18 years or older. JAMA Intern Med. 2021;181(12):1668‐70.doi: 10.1001/jamainternmed.2021.5511
8. Witberg G, Barda N, Hoss S, et al. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med. 2021;385(23):2132–39.doi: 10.1056/NEJMoa2110737
9. Yasmin F, Najeeb H, Naeem U, et al. Adverse events following Covid -19 mRNA vaccines: A systematic review of cardiovascular complication, thrombosis, and thrombocytopenia. Immun Inflamm Dis. 2023;11(3):e807. doi: 10.1002/iid3.807
10. Nappi C, Megna R, Acampa W, et al. Effects of the Covid-19 pandemic on myocardial perfusion imaging for ischemic heart disease. Eur J Nucl Med Mol Imaging. 2021;48(2):421–27. doi: 10.1007/s00259-020-04994-6
11. Verberne HJ, Acampa W, Anagnostopoulos C, et al. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. Eur J Nucl Med Mol Imaging. 2015;42(12):1929-40. doi: 10.1007/s00259-015-3139-x
12. Germano G, Kavanaugh PB, Waechter P, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. I: technical principles and reproducibility. J Nucl Cardiol. 2000;7(4):312-18. doi: 10.1067/mnc.2000.107766
13. Erol M, Tezcan H, Duran M, et al. The role of myocardial perfusion imaging in predicting myocardial ischemia in patients diagnosed with long Covid. Int J Cardiovasc Imaging. 2023;39(12):2279-84. doi: 10.1007/s10554-023-02928-5
14. Ghasemiyeh P, Mohammadi-Samani S, Firouzabadi N, et al. A focused review on technologies, mechanisms, safety, and efficacy of available Covid-19 vaccines. Int Immunopharmacol. 2021;100:108162.doi: 10.1016/j.intimp.2021.108162
15. Wu Q, Dudley MZ, Chen X, et al. Evaluation of the safety profile of Covid-19 vaccines: a rapid review. BMC Med. 2021;19(1):173. doi: 10.1186/s12916-021-02059-5
16. Barda N, Dagan N, Ben-Shlomo Y, et al. Safety of the BNT162b2 mRNA Covid-19 vaccine in a nationwide setting. N Engl J Med. 2021;385(12):1078–90. doi: 10.1056/NEJMoa2110475
17. Fraiman J, Erviti J, Jones M, et al. Serious adverse events of special interest following mRNA Covid-19 vaccination in randomized trials in adults. Vaccine. 2022;40(40):5798–05.doi: 10.1016/j.vaccine.2022.08.036
18. Chen L, Li X, Chen M, et al. The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res. 2020;116(6):1097–00.doi: 10.1093/cvr/cvaa078
19. Buoninfante A, Andeweg A, Genov G, et al. Myocarditis associated with Covid-19 vaccination. npj Vaccines. 2024;9(1):122. doi: 10.1038/s41541-024-00893-1
20. Bozkurt B, Kamat I, Hotez PJ. Myocarditis with Covid-19 mRNA vaccines. Circulation. 2021;144(6):471–84.doi: 10.1161/CIRCULATIONAHA.121.056135
21. Mevorach D, Anis E, Cedar N, et al. Myocarditis after BNT162b2 mRNA vaccine against Covid-19 in Israel. N Engl J Med. 2021;385(23):2140-49. doi: 10.1056/NEJMoa2109730
22. Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603-15. doi: 10.1056/NEJMoa2034577
23. Gimbrone MA Jr, García-Cardeña G. Endothelial cell dysfunction and the pathobiology of atherosclerosis. Circ Res. 2016;118(4):620-36. doi: 10.1161/CIRCRESAHA.115.306301
24. Deng H, Tang TX, Chen D, et al. Endothelial dysfunction and SARS-CoV-2 infection: association and therapeutic strategies. Pathogens. 2021;10(5):582.doi: 10.3390/pathogens10050582
25. Marchio P, Guerra-Ojeda S, Vila JM, et al. Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation. Oxid Med Cell Longev. 2019;2019:8563845.doi: 10.1155/2019/8563845
26. Maruhashi T, Soga J, Fujimura N, et al. Endothelial Dysfunction, Increased Arterial Stiffness, and Cardiovascular Risk Prediction in Patients With Coronary Artery Disease: FMD-J Study A. J Am Heart Assoc. 2018;7(14):e008588. doi: 10.1161/JAHA.118.008588
27. Lamprinou M, Sachinidis A, Stamoula E, et al. Covid-19 vaccines adverse events: potential molecular mechanisms. Immunol Res. 2023;71(3):356-72.doi: 10.1007/s12026-023-09357-5
28. Yamaji T, Harada T, Hashimoto Y, et al. Effects of BNT162b2 mRNA Covid-19 vaccine on vascular function. PLoS One. 2024;19(4):e0302512.doi: 10.1371/journal.pone.0302512
29. Karlstad Ø, Hovi P, Husby A, et al. SARS-CoV-2 vaccination and myocarditis in a Nordic cohort study of 23 million residents. JAMA Cardiol. 2023;8(6):595-05.doi: 10.1001/jamacardio.2022.0583
30. Patone, M., Mei, X. W., Handunnetthi, et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with Covid-19 vaccination or SARS-CoV-2 infection. Nature medicine. 2022;28(2);410–22. doi:10.1038/s41591-021-01630-0
31. Fronza M, Thavendiranathan P, Chan V, et al. Cardiac magnetic resonance findings in asymptomatic individuals after mRNA Covid-19 vaccination: a cohort study. JACC Cardiovasc Imaging. 2024;17(3):321-30.doi: 10.1148/radiol.212559
Keywords
