BackgroundMyocardial fibrosis, as quantified by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR), provides valuable prognostic information for patients with myocarditis. However, due to the low incidence rate of fulminant myocarditis (FM) and accordingly small sample size, the knowledge about the role of LGE to patients with FM is limited.Methods and resultsA total of 44 adults with viral-FM receiving the Chinese treating regimen were included in this retrospective study. They were divided into the low LGE group and the high LGE group according to the ratio of LGE to left ventricular mass (LGE mass%). CMR exams and LGE were performed after hemodynamic assistance at discharge in all patients with FM. Routine echocardiography parameters and global longitudinal strain (GLS) at discharge and at 2-year follow-up were obtained and then compared. Both left ventricular ejection fraction (LVEF) and GLS showed no significant difference in both groups at discharge, whereas significant differences were observed at 2-year follow-up between two groups. Moreover, there were significant improvements of LVEF and GLS in the low LGE group, but not in the high LGE group during the 2-year period. Furthermore, LGE mass% was negatively correlated with GLS and LVEF.ConclusionsThere were two distinct forms of LGE presentation in patients with FM. Moreover, the cardiac function of patients with low LGE was significantly better than those with high LGE at 2-year follow-up. LGE mass% at discharge provided significant prognosis information about cardiac function of patients with FM.

Background Although type 2 diabetes mellitus (T2DM) individuals easily develop three‐vessel disease (3VD) coronary artery disease (CAD), there is very little information available about their left ventricle (LV) functions. The purpose of this study is to evaluate the LV function using two‐dimensional speckle tracking echocardiography (2‐D STE) in T2DM patients with 3VD. Methods One hundred and three consecutive patients with confirmed 3VD CAD were enrolled and divided into two groups, while 53 patients with DM and 50 patients without. The control group was composed of 30 age‐ and sex‐matched healthy individuals. All patients underwent 2‐D STE and standard echocardiograms. The durations of DM and the level of HbA1c were also recorded. Result Between the 3VD‐DM and 3VD‐non‐DM groups, normal echocardiography did not reveal any appreciable differences. However, patients with 3VD‐DM had significantly lower global longitudinal strain (GLS) than those with 3VD‐non‐DM (15.87 ± 2.51 vs.17.56 ± 2.72, p < .05) by 2‐D STE strain measurement. Besides, patients whose duration of DM excess 5 years showed significant lower GLS than those with less than 5 years duration (14.25 ± 2.31 vs. 16.65 ± 1.96, p = .007). However, there was no difference in GLS between the 3VD‐DM patients with HbA1c ≥ 7% and HbA1c < 7%. Conclusions Compared to patients with 3VD alone, those with 3VD‐DM have a lower cardiac function. In 3VD‐DM patients, the duration of DM is a significant factor that contributes to cardiac function deterioration, whereas, the glucose control state has limited influence.