Observational Study

. 2025 Sep;18(9):e017420.

doi: 10.1161/CIRCIMAGING.124.017420. Epub 2025 Apr 4.

CMR Findings in the Long-Term Outcomes After Multisystem Inflammatory Syndrome in Children (MUSIC) Study

Sean M Lang¹, Dongngan T Truong², Andrew J Powell³, Valiantsina Kazlova⁴, Jane W Newburger³, Jordan D Awerbach⁵, Edem Binka², Tamara T Bradford⁶, Mark Cartoski⁷, Andrew Cheng⁸, Michael P DiLorenzo⁹, Audrey Dionne³, Adam L Dorfman¹⁰, Matthew D Elias¹¹, Olukayode Garuba¹², Jennifer F Gerardin¹³, Keren Hasbani¹⁴, Pei-Ni Jone^{15

16}, Christopher Z Lam¹⁷, Nilanjana Misra¹⁸, Lerraughn M Morgan¹⁹, Arni Nutting²⁰, Jyoti K Patel²¹, Joshua D Robinson¹⁵, Eleanor L Schuchardt²², Kristen Sexson Tejtel¹², Gautam K Singh²³, Timothy C Slesnick²⁴, Felicia Trachtenberg⁴, Michael D Taylor^{1

14}; MUSIC Study Investigators

Collaborators, Affiliations

Collaborators

MUSIC Study Investigators:
Gail Pearson, Victoria Pemberton, Kristin Burns, D'Andrea Freemon, Julie Miller, Felicia Trachtenberg, Kerri Hayes, Allison Crosby-Thompson, Ayesha Amarnath, James Ambrosoli, Cassandra Artis, Kay Rubio, Chitra Kinhikar, Amanda Marshall, P J Mu, Devine Mbiydzenyuy, Chenwei Hu, Lozan Eyob, Beverly Slayton, Lauren DiStefano, Jami Honig, Tiffany Bowie, Rob Nero, Emily Birmingham, Robin Rowe, Melissa Joyce, Cole Gallagher, Djenawa Bowman, Mo Zhang, Alissa Mooney, Sachin Bandari, Brian McCrindle, Andreea Dragulescu, Rae Yeung, Beth Gamulka, Jessica Bainton, Martha Rolland, Patti Walter, Simran Mahanta, Thomas Giorgio, Veronique Wright, Olivia Rossi, Numaira Khan, Annette Baker, Lisa Jean Buckley, Jessica Jones, LaTina Watson, Anna Clarke, Tor-Samuel-Aleer Leek, Gwendolyn Orav, Tonia Morrison, Katherine Lupton, Matthew Elias, Therese Giglia, Donna Sylvester, Dana Albizem, Kristin Lanzilotta, Grace Marks, Kimberly McHugh, Tyler Kasmarcak, Madison Johnson, Megan Bickford, Linda Lambert, Lilly Fagatele, Andrea Dunn, Emma Joyce, Mark Russell, Tammy Doman, Lori Harris, Elise Pickering, Marisa Almaguer, Lauryn Dugan, Kathleen Rathge, Elizabeth Seibert, Mark Payne, Mary Stumpf, Jennifer Howell, Nancy Kehlenbrink, Gloria Mitscher, Matthew E Oster, Melissa Burnett, Kolby Sanders-Lewis, Morgan Van Dresser, Beatrice Doe-Printemps, Brooke Evans, William T Mahle, Lazaros Kochilas, Madison Rudow, Susie Gentry, Kristie Le, Caitlen Taylor, Lara Shekerdemian, Faridis Serrano, Elias Moussi, Sandra Pena, Ricardo Pignatelli, Asela Liu, Kanwal Farooqi, Amee Shah, Brett Anderson, Neeka Karaminian, Katrina Golub, Chantal Sanchez, Chanel Rojas, Karen Martyrosyan, Jacqueline R Szmuszkovicz, Sindhu Mohandas, Jodie K Votava-Smith, Shuo Wang, Pierre C Wong, Jennifer Su, Allison Garcia, Anastasia Sarkissian, Matthew Dam, Javier Medina, Kavita Sharma Pi, Catherine Ikemba, Maria Martinez, Parvin Mohazabnia, Wendy Rojas, Delaney Evans, Stephanie Handler, Joe Block, Regina Cole, Jennifer Maldonado, Shubhika Srivastava, Deepika Thacker, Carol Prospero, Varsha Zadokar, Ed Williams, Bridgette Hindt, Pei-Ni, Michael Carr, Kathleen Van't Hof, Lauren Goodel, Colleen Sullivan, Jason Lu, Michael A Portman, Aaron Olson, Eyal Sagiv, Sujatha Buddhe, Hidemi Kajimoto, Deepthi G Nair, Mikayla A Beckley, Camilla Pedroso, Cisco Pedroso, Kirsten Dummer, Joan Pancheri, Katheryn Crane, Sherrie Bandy, Anita Krishnan, Ashraf Harahsheh, Charles Berul, Laura Olivieri, Jordyn Britton, Mitchell Haverty, Alix Fetch, Christina Schott, Sarah Litt, Daniel Forsha, Jennifer Nelson, Dara Watkins, Michelle Hite, Isabel Glassmeyer, Suchitra Rao, Heather Heizer, Sonia Chavez, Arash Sabati, Ashley Herzberg, Samantha Stack, Jade Porche, Megan Warner, Susan Park, Amy Johnson, Amy Ellerbe, Kathleen Nagaran Hildebrand, Divya Shakti, Aimee S Parnell, Onyekachukwu Osakwe, Michael D Weiland, Phenique Parker, Jeffrey A Kertis, Charlotte V Hobbs, Candace M Howard, Shivraj Savadkar, Aren E Worrell, Madelyn R Barr, Heather Williams, David Gordy, Preeti Vemula, Zachary White, Jemylle Grace S Morato, Sandra Tyler, Camden Hebson, Krissie Hock, Michelle Sykes, Carl Owada, Mayra Lemus Rangel, Isaura Macias, Tania Jimenez, Yamuna Sanil, Sanjeev Aggarwal, Charmaine Williams-Farr, Nancy Sullivan, Aiman Almasnaah, Vishnu Undyala, Brian Hannah, Mary McCall, Emily Ward, Louisa Keith, Antonette Salazar, Sagar Jani, Jacob Strelow, Rachel Downey, Ken Shaffer, Chesney Castleberry, Lisa Pomeroy, Rachel Amsellem, Elizabeth Mitchell, Olga Shamailova, Arlett Zelaya, Marla Johnston, Juan Carlos Muniz, Moya Chang, Ryan Shea, Miriam Davis, Maryanne Chrisant, Danielle Katz, Norma Jean Barton, Doris Alaby, Paulette Smith, Bukky Oni, Raquel Ferreira, Patrick McGeoghegan, Michael Taylor, Joshua Germann, Andrew Mackie, Jogarao Gobburu, Sally Hunsberger, Patrick McQuillen, Michael Spaeder, Dianne Atkins, Craig Broberg, David J Driscoll, Frank Evans, Sally A Hunsberger, Liza-Marie Johnson, Thomas J Knight, Paul Lipkin, J Philip Saul

Affiliations

¹ Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.M.L., M.D.T.).
² Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City (D.T.T., E.B.).
³ Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, MA (A.J.P., J.W.N., A.D.).
⁴ Carelon, Inc, Morristown, NJ (V.K., F.T.).
⁵ Division of Cardiology, Phoenix Children's Hospital, Divisions of Children Health and Internal Medicine, University of Arizona College of Medicine-Phoenix (J.D.A.).
⁶ Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans (T.T.B.).
⁷ Nemours Cardiac Center, Nemours Children's Health, Wilmington, DE (M.C.).
⁸ Division of Cardiology, Department of Pediatrics Children's Hospital Los Angeles, Keck School of Medicine, CA (A.C.).
⁹ Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Morgan Stanley Children's Hospital (M.P.D.L.).
¹⁰ Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor (A.L.D.).
¹¹ Division of Cardiology, The Children's Hospital of Philadelphia, PA (M.D.E.).
¹² Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston (O.G., K.S.T.).
¹³ Division of Pediatric Cardiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee (J.F.G.).
¹⁴ Division of Pediatric Cardiology, Department of Pediatrics, Dell Children's Medical Center, Dell Medical School, Austin, TX (K.H., M.D.T.).
¹⁵ Department of Pediatrics, Pediatric Cardiology, Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL (P.-N.J., J.D.R.).
¹⁶ Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (P.-N.J.).
¹⁷ Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Canada (C.Z.L.).
¹⁸ Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY (N.M.).
¹⁹ Department of Pediatrics, Valley Children's Healthcare, Madera, CA (L.M.M.).
²⁰ Division of Pediatric Cardiology, Medical University of South Carolina, Charleston (A.N.).
²¹ Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis (J.K.P.).
²² Division of Cardiology, Rady Children's Hospital, Department of Pediatrics University of California San Diego School of Medicine (E.L.S.).
²³ Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit (G.K.S.).
²⁴ Children's Heart Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, GA (T.C.S.).

PMID: 40181776
PMCID: PMC12353833 (available on 2026-04-04)
DOI: 10.1161/CIRCIMAGING.124.017420

Observational Study

CMR Findings in the Long-Term Outcomes After Multisystem Inflammatory Syndrome in Children (MUSIC) Study

Sean M Lang et al. Circ Cardiovasc Imaging. 2025 Sep.

. 2025 Sep;18(9):e017420.

doi: 10.1161/CIRCIMAGING.124.017420. Epub 2025 Apr 4.

Authors

Collaborators

MUSIC Study Investigators:
Gail Pearson, Victoria Pemberton, Kristin Burns, D'Andrea Freemon, Julie Miller, Felicia Trachtenberg, Kerri Hayes, Allison Crosby-Thompson, Ayesha Amarnath, James Ambrosoli, Cassandra Artis, Kay Rubio, Chitra Kinhikar, Amanda Marshall, P J Mu, Devine Mbiydzenyuy, Chenwei Hu, Lozan Eyob, Beverly Slayton, Lauren DiStefano, Jami Honig, Tiffany Bowie, Rob Nero, Emily Birmingham, Robin Rowe, Melissa Joyce, Cole Gallagher, Djenawa Bowman, Mo Zhang, Alissa Mooney, Sachin Bandari, Brian McCrindle, Andreea Dragulescu, Rae Yeung, Beth Gamulka, Jessica Bainton, Martha Rolland, Patti Walter, Simran Mahanta, Thomas Giorgio, Veronique Wright, Olivia Rossi, Numaira Khan, Annette Baker, Lisa Jean Buckley, Jessica Jones, LaTina Watson, Anna Clarke, Tor-Samuel-Aleer Leek, Gwendolyn Orav, Tonia Morrison, Katherine Lupton, Matthew Elias, Therese Giglia, Donna Sylvester, Dana Albizem, Kristin Lanzilotta, Grace Marks, Kimberly McHugh, Tyler Kasmarcak, Madison Johnson, Megan Bickford, Linda Lambert, Lilly Fagatele, Andrea Dunn, Emma Joyce, Mark Russell, Tammy Doman, Lori Harris, Elise Pickering, Marisa Almaguer, Lauryn Dugan, Kathleen Rathge, Elizabeth Seibert, Mark Payne, Mary Stumpf, Jennifer Howell, Nancy Kehlenbrink, Gloria Mitscher, Matthew E Oster, Melissa Burnett, Kolby Sanders-Lewis, Morgan Van Dresser, Beatrice Doe-Printemps, Brooke Evans, William T Mahle, Lazaros Kochilas, Madison Rudow, Susie Gentry, Kristie Le, Caitlen Taylor, Lara Shekerdemian, Faridis Serrano, Elias Moussi, Sandra Pena, Ricardo Pignatelli, Asela Liu, Kanwal Farooqi, Amee Shah, Brett Anderson, Neeka Karaminian, Katrina Golub, Chantal Sanchez, Chanel Rojas, Karen Martyrosyan, Jacqueline R Szmuszkovicz, Sindhu Mohandas, Jodie K Votava-Smith, Shuo Wang, Pierre C Wong, Jennifer Su, Allison Garcia, Anastasia Sarkissian, Matthew Dam, Javier Medina, Kavita Sharma Pi, Catherine Ikemba, Maria Martinez, Parvin Mohazabnia, Wendy Rojas, Delaney Evans, Stephanie Handler, Joe Block, Regina Cole, Jennifer Maldonado, Shubhika Srivastava, Deepika Thacker, Carol Prospero, Varsha Zadokar, Ed Williams, Bridgette Hindt, Pei-Ni, Michael Carr, Kathleen Van't Hof, Lauren Goodel, Colleen Sullivan, Jason Lu, Michael A Portman, Aaron Olson, Eyal Sagiv, Sujatha Buddhe, Hidemi Kajimoto, Deepthi G Nair, Mikayla A Beckley, Camilla Pedroso, Cisco Pedroso, Kirsten Dummer, Joan Pancheri, Katheryn Crane, Sherrie Bandy, Anita Krishnan, Ashraf Harahsheh, Charles Berul, Laura Olivieri, Jordyn Britton, Mitchell Haverty, Alix Fetch, Christina Schott, Sarah Litt, Daniel Forsha, Jennifer Nelson, Dara Watkins, Michelle Hite, Isabel Glassmeyer, Suchitra Rao, Heather Heizer, Sonia Chavez, Arash Sabati, Ashley Herzberg, Samantha Stack, Jade Porche, Megan Warner, Susan Park, Amy Johnson, Amy Ellerbe, Kathleen Nagaran Hildebrand, Divya Shakti, Aimee S Parnell, Onyekachukwu Osakwe, Michael D Weiland, Phenique Parker, Jeffrey A Kertis, Charlotte V Hobbs, Candace M Howard, Shivraj Savadkar, Aren E Worrell, Madelyn R Barr, Heather Williams, David Gordy, Preeti Vemula, Zachary White, Jemylle Grace S Morato, Sandra Tyler, Camden Hebson, Krissie Hock, Michelle Sykes, Carl Owada, Mayra Lemus Rangel, Isaura Macias, Tania Jimenez, Yamuna Sanil, Sanjeev Aggarwal, Charmaine Williams-Farr, Nancy Sullivan, Aiman Almasnaah, Vishnu Undyala, Brian Hannah, Mary McCall, Emily Ward, Louisa Keith, Antonette Salazar, Sagar Jani, Jacob Strelow, Rachel Downey, Ken Shaffer, Chesney Castleberry, Lisa Pomeroy, Rachel Amsellem, Elizabeth Mitchell, Olga Shamailova, Arlett Zelaya, Marla Johnston, Juan Carlos Muniz, Moya Chang, Ryan Shea, Miriam Davis, Maryanne Chrisant, Danielle Katz, Norma Jean Barton, Doris Alaby, Paulette Smith, Bukky Oni, Raquel Ferreira, Patrick McGeoghegan, Michael Taylor, Joshua Germann, Andrew Mackie, Jogarao Gobburu, Sally Hunsberger, Patrick McQuillen, Michael Spaeder, Dianne Atkins, Craig Broberg, David J Driscoll, Frank Evans, Sally A Hunsberger, Liza-Marie Johnson, Thomas J Knight, Paul Lipkin, J Philip Saul

Affiliations

¹ Heart Institute, Cincinnati Children's Hospital Medical Center, OH (S.M.L., M.D.T.).
² Department of Pediatrics, Division of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City (D.T.T., E.B.).
³ Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, MA (A.J.P., J.W.N., A.D.).
⁴ Carelon, Inc, Morristown, NJ (V.K., F.T.).
⁵ Division of Cardiology, Phoenix Children's Hospital, Divisions of Children Health and Internal Medicine, University of Arizona College of Medicine-Phoenix (J.D.A.).
⁶ Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans (T.T.B.).
⁷ Nemours Cardiac Center, Nemours Children's Health, Wilmington, DE (M.C.).
⁸ Division of Cardiology, Department of Pediatrics Children's Hospital Los Angeles, Keck School of Medicine, CA (A.C.).
⁹ Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Morgan Stanley Children's Hospital (M.P.D.L.).
¹⁰ Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor (A.L.D.).
¹¹ Division of Cardiology, The Children's Hospital of Philadelphia, PA (M.D.E.).
¹² Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston (O.G., K.S.T.).
¹³ Division of Pediatric Cardiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee (J.F.G.).
¹⁴ Division of Pediatric Cardiology, Department of Pediatrics, Dell Children's Medical Center, Dell Medical School, Austin, TX (K.H., M.D.T.).
¹⁵ Department of Pediatrics, Pediatric Cardiology, Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL (P.-N.J., J.D.R.).
¹⁶ Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (P.-N.J.).
¹⁷ Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Canada (C.Z.L.).
¹⁸ Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY (N.M.).
¹⁹ Department of Pediatrics, Valley Children's Healthcare, Madera, CA (L.M.M.).
²⁰ Division of Pediatric Cardiology, Medical University of South Carolina, Charleston (A.N.).
²¹ Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis (J.K.P.).
²² Division of Cardiology, Rady Children's Hospital, Department of Pediatrics University of California San Diego School of Medicine (E.L.S.).
²³ Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit (G.K.S.).
²⁴ Children's Heart Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, GA (T.C.S.).

PMID: 40181776
PMCID: PMC12353833 (available on 2026-04-04)
DOI: 10.1161/CIRCIMAGING.124.017420

Abstract

Background: Multisystem Inflammatory Syndrome in Children is characterized by high rates of acute cardiovascular involvement with rapid recovery of organ dysfunction. However, information regarding long-term sequelae is lacking. We sought to characterize the systolic function and myocardial tissue properties using cardiac magnetic resonance (CMR) imaging in a multicenter observational cohort of patients with Multisystem Inflammatory Syndrome in Children.

Methods: In this observational cohort study, comprising 32 centers in North America, CMR studies were analyzed by a core laboratory to assess ventricular volumetric data, tissue characterization, and coronary involvement.

Results: A total of 263 CMRs from 255 patients with Multisystem Inflammatory Syndrome in Children were analyzed. The mean patient age was 11.4±4.4 years. Most studies were performed at 3 months (33%) or 6 months (45%) after hospitalization. Left ventricular dysfunction was present in 17 (6.7%) of the first CMRs and was never worse than mild. Dysfunction was observed in 4/7 (57%) patients at admission, 5/87 (6.9%) patients at 3 months, and 6/129 (4.6%) patients imaged either at 6 months or 1 year post-hospitalization. Late gadolinium enhancement was present in 2 (0.8%) patients, 1 at 3 months and another at 6 months following hospitalization. Coronary artery dilation was present in 13 of the 174 (7.5%) patients. Nine patients met the Lake Louise criteria for myocarditis (3.5%) at the time of CMR.

Conclusions: In this largest published multiinstitutional longitudinal CMR evaluation of confirmed patients with Multisystem Inflammatory Syndrome in Children, the prevalence of ventricular dysfunction and myocardial tissue characterization abnormalities on medium-term follow-up was low. However, a small number of patients had mild residual abnormalities at 6 months and 1 year following hospitalization.

Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05287412.

Keywords: child; dilatation; humans; myocarditis; prevalence.

PubMed Disclaimer

Conflict of interest statement

Drs Truong and Lang are co-PIs on a study funded by Pfizer, Inc on COVID-19 vaccine related myocarditis. Dr DiLorenzo has received research support from Genentech, Inc. The other authors report no conflicts.

Comment in

Multimodality Imaging in MIS-C Recovery: Complementary Insights From Echocardiography and Cardiac MRI.
Isaac Maximo LM, Mavrogeni SI, Mukherjee M. Isaac Maximo LM, et al. Circ Cardiovasc Imaging. 2025 Sep;18(9):e018872. doi: 10.1161/CIRCIMAGING.125.018872. Epub 2025 Aug 26. Circ Cardiovasc Imaging. 2025. PMID: 40875381 No abstract available.

References

1. WHO Health Emergency Dasboard. In: Available from: https://covid19whoint/; Access date: January, 1, 2024.
1. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, Shchendrygina A, Escher F, Vasa-Nicotera M, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020; 5:1265–1273. - PMC - PubMed
1. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020; 395:1607–1608. - PMC - PubMed
1. CDC COVID Data Tracker. In: Available from: https://covidcdcgov/covid-datatracker/#demographics; Access Date: January 1, 2024
1. Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K, Klein JD, Bhutta ZA. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020; 20:e276–e288. - PMC - PubMed

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CMR Findings in the Long-Term Outcomes After Multisystem Inflammatory Syndrome in Children (MUSIC) Study

Collaborators

Affiliations

CMR Findings in the Long-Term Outcomes After Multisystem Inflammatory Syndrome in Children (MUSIC) Study

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Supplementary concepts

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous