Comparison of Original and 2018 Lake Louise Criteria for Diagnosis of Acute Myocarditis: Results of a Validation Cohort

Luetkens, Julian A.; Faron, Anton; Isaak, Alexander; Dabir, Darius; Kuetting, Daniel; Feißt, Andreas; Schmeel, Frederic Carsten; Sprinkart, Alois M.; Thomas, Daniel

doi:10.1148/ryct.2019190010

Cited by 149 publications

(130 citation statements)

References 29 publications

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“…The search in PubMed and Embase revealed respectively 555 and 545 articles, and one article was manually added [38]. After removal of the duplicates, 704 articles remained for evaluation of title and abstract which resulted in 154 articles included for the final meta-analysis (Table 1).…”

Section: Literature Searchmentioning

confidence: 99%

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Cardiovascular magnetic resonance native T2 and T2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis

Snel

Boomen

Hernández

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: The clinical application of cardiovascular magnetic resonance (CMR) T 2 and T 2 * mapping is currently limited as ranges for healthy and cardiac diseases are poorly defined. In this meta-analysis we aimed to determine the weighted mean of T 2 and T 2 * mapping values in patients with myocardial infarction (MI), heart transplantation, non-ischemic cardiomyopathies (NICM) and hypertension, and the standardized mean difference (SMD) of each population with healthy controls. Additionally, the variation of mapping outcomes between studies was investigated. Methods: The PRISMA guidelines were followed after literature searches on PubMed and Embase. Studies reporting CMR T 2 or T 2 * values measured in patients were included. The SMD was calculated using a random effects model and a meta-regression analysis was performed for populations with sufficient published data. Results: One hundred fifty-four studies, including 13,804 patient and 4392 control measurements, were included. T 2 values were higher in patients with MI, heart transplantation, sarcoidosis, systemic lupus erythematosus, amyloidosis, hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM) and myocarditis (

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Section: Literature Searchmentioning

confidence: 99%

“…The weighted mean T 2 values at 1.5 T in myocarditis patients was 61.9 ± 11.5 ms and 54.4 ± 5.9 ms in controls [25,38,[171][172][173][174][175][176][177][178][179][180][181][182][183][184][185] (Table 1, Fig. 5).…”

Section: Myocarditismentioning

confidence: 99%

Cardiovascular magnetic resonance native T2 and T2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis

Snel

Boomen

Hernández

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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“…Individual constituents of the uLLc were not demonstrated to have highly divergent diagnostic value from the oLLc in a recent meta-analysis [38]. To our knowledge, since the publication of the uLLc, only a single study has reported comparisons between them and the oLLc, mainly citing higher sensitivity and specificity for the uLLc [39]. However, since the criteria were not compared with a diagnostic gold standard, the use of the terms sensitivity and specificity are not appropriate [40].…”

Section: Discussionmentioning

confidence: 99%

The Double-Edged Sword of T1-Mapping in Systemic Sclerosis—A Comparison with Infectious Myocarditis Using Cardiovascular Magnetic Resonance

et al. 2020

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Aims: T1-mapping is considered a surrogate marker of acute myocardial inflammation. However, in diffuse cutaneous systemic sclerosis (dcSSc) this might be confounded by coexisting myocardial fibrosis. We hypothesized that T1-based indices should not by themselves be considered as indicators of myocardial inflammation in dcSSc patients. Methods/Results: A cohort of 59 dcSSc and 34 infectious myocarditis patients was prospectively evaluated using a 1.5-Tesla system for an indication of suspected myocardial inflammation and was compared with 31 healthy controls. Collectively, 33 (97%) and 57 (98%) of myocarditis and dcSSc patients respectively had ≥1 pathologic T2-based index. However, 33 (97%) and 45 (76%) of myocarditis and dcSSc patients respectively had ≥1 pathologic T2-based index. T2-signal ratio was significantly higher in myocarditis patients compared with dcSSc patients (2.5 (0.6) vs. 2.1 (0.4), p < 0.001). Early gadolinium enhancement, late gadolinium enhancement and T2-mapping did not differ significantly between groups. However, both native T1-mapping and extracellular volume fraction were significantly lower in myocarditis compared with dcSSc patients (1051.0 (1027.0, 1099.0) vs. 1120.0 (1065.0, 1170.0), p < 0.001 and 28.0 (26.0, 30.0) vs. 31.5 (30.0, 33.0), p < 0.001, respectively). The original Lake Louise criteria (LLc) were positive in 34 (100%) myocarditis and 40 (69%) dcSSc patients, while the updated LLc were positive in 32 (94%) and 44 (76%) patients, respectively. Both criteria had good agreement with greater but nonsignificant discordance in dcSSc patients. Conclusions: ~25% of dcSSc patients with suspected myocardial inflammation had no CMR evidence of acute inflammatory processes. T1-based indices should not be used by themselves as surrogates of acute myocardial inflammation in dcSSc patients.

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“…In 2018, consensus guidelines recommended the addition of T2-weighted cardiac MRI to the pre-existing Lake Louise criteria (LLC) for the diagnosis of myocarditis 162 . The 2018 LLC showed better diagnostic performance than the original criteria owing to increased sensitivity 163 . T1 and T2 mapping have added further diagnostic information and accuracy to cardiac MRI [164][165][166][167][168][169] .…”

Section: Imagingmentioning

confidence: 93%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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Inflammatory cardiomyopathy is defined as myocarditis in association with cardiac dysfunction and ventricular remodelling 1,2. Despite extensive research and improved diagnosis and understanding of the pathogenesis of inflammatory cardiomyopathy, this disorder is still associated with a poor prognosis when complicated by left ventricular (LV) dysfunction, heart failure (HF) or arrhythmia 3. Furthermore, fulminant myocarditis, a rare, sudden and severe cardiac inflammation, is one of the main causes of cardiogenic shock in young adults 4,5. Prompt diagnosis and specific treatment strategies are needed to reduce mortality and the need for heart transplantation in these patients 4,5. Many questions remain unanswered regarding the pathogenesis of inflammatory cardiomyopathy and the role of the viral infection, the immune system, the host genetic background and the environment in disease progression and prognosis. These gaps in knowledge highlight the need for advanced experimental systems that can better model the human immune system and the need to improve the characterization and classification of the patients, for example, with the use of phenomapping and phenomics, which involve detailed evaluation of immune status, viral presence and/or other biomarkers. In this Review, we discuss the available evidence and identify the gaps in our understanding of the pathogenesis, diagnosis, treatment and prognosis of myocarditis and inflammatory cardiomyopathy, appraise the available animal and cell models of these conditions and propose future directions for the field. We discuss the role

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Comparison of Original and 2018 Lake Louise Criteria for Diagnosis of Acute Myocarditis: Results of a Validation Cohort

Cited by 149 publications

References 29 publications

Cardiovascular magnetic resonance native T2 and T2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis

Cardiovascular magnetic resonance native T2 and T2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis

The Double-Edged Sword of T1-Mapping in Systemic Sclerosis—A Comparison with Infectious Myocarditis Using Cardiovascular Magnetic Resonance

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

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