Correlation between clinical presentation and delayed-enhancement MRI pattern in myocarditis

Natale, Luigi; Vita, Antonio De; Baldari, Chiara; Meduri, Agostino; Pieroni, Maurizio; Lombardo, Antonella; Crea, Filippo; Bonomo, Lorenzo

doi:10.1007/s11547-012-0790-x

Cited by 8 publications

(2 citation statements)

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“…Specifically, the initial presentation of chest pain being the most common, followed by dyspnoea, is consistent with most studies. [4][5][6][7] However, fever was not always reported, 6 in contrast to our analysis where fever was always present regardless of the type of the infection. ECG findings on admission consisted mainly of non-specific repolarization abnormalities, while echocardiographic findings revealed mainly regional hypokinesia, which is consistent with other studies' findings.…”

Section: Discussioncontrasting

confidence: 92%

“…Our findings are mostly consistent with those reported in literature. Specifically, the initial presentation of chest pain being the most common, followed by dyspnoea, is consistent with most studies 4–7 . However, fever was not always reported, 6 in contrast to our analysis where fever was always present regardless of the type of the infection.…”

Section: Discussionsupporting

confidence: 91%

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HEllenic Registry on Myocarditis SyndromES on behalf of Hellenic Heart Failure Association: The HERMES‐HF Registry

et al. 2020

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Aims Despite the existence of many studies, there are still limited data about the characteristics of myocarditis in Greece. This led to the creation of the Greek Myocarditis Registry aiming to document the different symptoms and treatment of myocarditis, assess possible prognostic factors, and find similarities and differences to what is already published in literature. This paper is a preliminary descriptive analysis of this Registry. Methods and results We analysed data for the hospitalization period of all patients included in the Registry from December 2015 until November 2017. Statistics are reported as frequency (%) or median and inter-quartile range (IQR) as appropriate. In total, 146 patients were included; 83.3% of the patients reported an infection during the last 3 months. The most common symptom, regardless of the underlying infection, was chest pain (82.2%) followed by dyspnoea (18.5%), while the most common finding in clinical examination was tachycardia (26.7%). Presentation was more frequent in the winter months. ECG findings were not specific, with the repolarization abnormalities being the most frequent (60.3%). Atrial fibrillation was observed in two patients, both of whom presented with a reduced ventricular systolic function. Left ventricular ejection fraction changed significantly during the hospitalization [55% (IQR: 50-60%) on admission vs. 60% (IQR: 55-60%) on discharge, P = 0.0026]. Cardiac magnetic resonance was performed in 88 patients (61%), revealing mainly subepicardial and midcardial involvement of the lateral wall. Late gadolinium enhancement was present in all patients, while oedema was found in 39 of them. Only 11 patients underwent endomyocardial biopsy. Discharge medication consisted mainly of beta-blockers (71.9%) and angiotensin-converting enzyme inhibitors (41.8%), while 39.7% of the patients were prescribed both.

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

HEllenic Registry on Myocarditis SyndromES on behalf of Hellenic Heart Failure Association: The HERMES‐HF Registry

et al. 2020

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Tissue Characterization by Mapping and Strain Cardiac MRI to Evaluate Myocardial Inflammation in Fulminant Myocarditis

Zhu

Yang

et al. 2020

Magnetic Resonance Imaging

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BackgroundThe clinical value of novel mapping techniques and strain measures to assess myocardial inflammation in fulminant myocarditis (FM) has not been fully explored.PurposeTo evaluate the ability of mapping and strain cardiac MRI to assess myocardial inflammation in patients with FM, and to which degree the strain metrics correlate with myocardial edema.Study TypeProspective.PopulationTwenty‐nine patients (37 ± 16 years, 48% male) with FM and 29 patients with nonfulminant acute myocarditis (NFAM) (29 ± 14 years, 69% male).Field Strength/Sequence3.0T; Cine imaging, black blood T2‐weighted imaging, T1mapping, T2 mapping, and late gadolinium enhancement.AssessmentNative T1, extracellular volume (ECV), and T2 were measured. Myocardial strain was evaluated by feature tracking.Statistical TestsStudent's t‐ or Mann–Whitney U‐test. Spearman correlation analysis.ResultsThe myocardial edema rate (2.6 ± 0.7 vs. 1.6 ± 0.2, P < 0.001) and late gadolinium enhancement (LGE) mass (16.5 [11.7, 41.7] vs. 6.9 [2.2, 15.8] g, P < 0.001) were significantly increased in FM patients when compared to the NFAM group. LGE in the FM group was predominantly located in the septal wall, and 38% of the patients showed a diffuse LGE pattern. Native T1, ECV, and T2 values in the FM group were significantly more elevated than those with NFAM, while global peak radial, circumferential, and longitudinal strain values were significantly reduced (all P < 0.001). Circumferential strain showed the strongest correlations with ECV (r = 0.72, P < 0.001).Data ConclusionPatients with FM showed significant differences in LGE patterns, increased edema, and decreased strain measurements compared to those with NFAM. Circumferential strain showed significant associations with quantitative cardiac MRI parameters of myocardial inflammation.Level of Evidence2Technical Efficacy Stage2 J. Magn. Reson. Imaging 2020;52:930–938.

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Cardiac Magnetic Resonance in Fulminant Myocarditis

Wang

2022

Fulminant Myocarditis

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Correlation between clinical presentation and delayed-enhancement MRI pattern in myocarditis

Abstract: Contrast-enhanced MRI is useful both in the diagnosis and as a prognostic indicator in the clinical suspicion of myocarditis.

Cited by 8 publications

References 28 publications

HEllenic Registry on Myocarditis SyndromES on behalf of Hellenic Heart Failure Association: The HERMES‐HF Registry

HEllenic Registry on Myocarditis SyndromES on behalf of Hellenic Heart Failure Association: The HERMES‐HF Registry

Tissue Characterization by Mapping and Strain Cardiac MRI to Evaluate Myocardial Inflammation in Fulminant Myocarditis

Cardiac Magnetic Resonance in Fulminant Myocarditis

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