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Background: The exact morbidity of myocarditis is unknown, as the treatment is generally delayed in virtue of misdiagnosis or missed diagnosis. Aim: The aim of this study was to identify prognostic factors of left-ventricular remodeling on CMRI performed in patients with pathological proven myocarditis. Methods: Sixty-two cases with various presentations of myocarditis (39 cases with heart failure; 23 cases with arrhythmias) were selected. All patients, who underwent coronary angiography, endomyocardial biopsy, were divided into positive-remodeling and negative-remodelling groups to analyse LGE and cardiac cine parameters at presentation and subsequent to 3 months. Results: Comparison of two subgroups in CMRI is as follows: positive LGE (65.6% vs. 86.7%; p<0.05), LVEF (41.3±14.8% vs. 37.6±10.1%; p=0.62), (25.7±2.0% vs. 24.0±2.5%; p=0.81), (44.5±3.9mm vs. 46.3±5.4mm; p=0.76), (129.1±8.5ml vs. 135.3±12.2ml; p=0.26), (74.8±7.3ml vs. 79.1±10.0ml; p=0.55), (52.0±5.7g vs. 49.6±6.5g; p=0.71), (34.9±3.5ml vs. 32.4±6.2ml; p=0.68), (3.8±0.7L/min vs. 3.1±0.5L/min; p=0.64), (2.9±0.6L/min*m2 vs. 2.7±0.5L/min*m2; p=0.79). Conclusion: LGE-MRI is rewarding as an independent predictor in left-ventricular positive and negative remodelling of myocarditis.

Background: Myocarditis does not have typical clinical manifestations and thus is difficult to accurately diagnose by virtue of infection history, and electrocardiogram (EKG) and peripheral blood abnormalities.Endomyocardial biopsy is the gold standard for diagnosis of myocarditis, but is invasive, high risk, and has an observational blind area. Cardiac magnetic resonance imaging (CMRI) is multiparameter and multidirectional with high spatial resolution and high contrast of soft tissue. However, the optimal method of calculating left ventricular (LV) function in patients with apical-segment-injured myocarditis is unresolved.We compared and analyzed the differences between two different methods (Simpson and 4D B-spline surface model (known as the 4D method)) of measuring LV function by CMRI in patients with myocarditis in the 17th segment of the left ventricle. Methods:The basic clinical data of two groups (myocarditis and non-myocarditis) were statistically analyzed, and differences in the LV function parameters by the two imaging methods were compared in the myocarditis group. Receiver-operating characteristic curves of single parameters and combined parameters based on the Simpson and 4D methods were drawn and the area under the curve, diagnostic threshold, maximum sensitivity interval, and maximum specificity interval were calculated.Results: In the myocarditis and non-myocarditis groups the respective number of patients was 22 and 17, the percentage of males was 54.55% and 47.06%, and the average age was 32.20±11.59 and 43.06±11.62 years. The difference in LV ejection fraction (LVEF) (P=0.033) and LV end systolic volume (LVESV) (P=0.030) in the myocarditis group was statistically significant. The respective AUCs based on the Simpson and 4D methods were LVEF 0.602 vs. 0.778, LVESV 0.556 vs. 0.751, LVEF-and-LVESV 0.634 vs. 0.775. Based on the 4D method, the diagnostic thresholds of LVEF and LVESV were 34.965 (sensitivity 0.882, specificity 0.591) and 69.090 (sensitivity 0.727, specificity 0.706), the maximum sensitivity intervals of LVEF and

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