LGE-MRI in the Assessment of Left-ventricular Remodelling in Myocarditis

Abstract

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.

Parametric Mapping Cardiac Magnetic Resonance Imaging for the Diagnosis of Myocarditis in Children in the Era of COVID-19 and MIS-C

“…Subepicardial inferolateral LGE is the most common pattern in adult patients with acute myocarditis [ 27 ]. In contrast, a higher prevalence of a mid-wall or mixed LGE pattern is reported in pediatric patients [ 27 ].…”

“…Subepicardial inferolateral LGE is the most common pattern in adult patients with acute myocarditis [ 27 ]. In contrast, a higher prevalence of a mid-wall or mixed LGE pattern is reported in pediatric patients [ 27 ]. The mid-wall or mixed pattern of LGE was associated with more severe disease progression and a higher complication rate than the subepicardial inferolateral pattern [ 28 , 29 ].…”

Long non-coding RNA LUCAT1 inhibits myocardial oxidative stress and apoptosis after myocardial infarction via targeting microRNA-181a-5p

“…Coronary artery occlusion caused by unstable plaque rupture and erosion secondary thrombosis is the main characteristic of AMI [ 2 ]. Due to the insufficient blood and oxygen supply from the coronary artery, the main clinical manifestation of patients is persistent and severe pain behind the sternum, which poses a serious threat to the patient’s health and even life safety [ 3 , 4 ]. In recent years, with the establishment of chest pain centers in various regions as well as the progress of thrombolytic therapy and stent implantation, the mortality of patients with AMI has been significantly reduced [ 5 ].…”

Função e caracterização tecidual miocárdica em pacientes com miopericardite idiopática aguda por ressonância magnética cardíaca: análise evolutiva

“…Realce tardio não teve correlação com a evolução em pacientes com MPA80 . Essa mesma correlação entre edema e incremento de FEVE ou realce tardio a longo prazo não encontramos em nosso estudo, possivelmente, em relação da seleção diferente de pacientes com menor quantidade de pacientes com disfunção ventricular à RMC inicial.De maneira oposta, Yuan et al98 em 2018 estudaram 62 pacientes com MPA cuja apresentação clínica foram arritmias e IC e mostraram que a presença de realce tardio foi associação a ocorrência de remodelamento cardíaco negativo, após 3 meses de seguimento (65,6% no grupo sem realce tardio vs. 86,7% no grupo com realce tardio, p < 0,05) 98 . De maneira semelhante, estudo publicado em 2016, avaliou 76 pacientes com MPA e RMC, e, em 49 pacientes, foi realizada segunda RMC após 148 dias.…”