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Cardiovascular magnetic resonance early predictors of unfavorable left ventricle remodeling in patients with acute myocarditis.

Session Poster session 1

Speaker Anna Palmisano

Congress : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance: Myocardium
  • Session type : Poster Session
  • FP Number : P177

Authors : A Palmisano (Milan,IT), G Benedetti (Milan,IT), D Palumbo (Milan,IT), G Peretto (Milan,IT), S Sala (Milan,IT), F De Cobelli (Milan,IT), A Esposito (Milan,IT)

Authors:
A Palmisano1 , G Benedetti1 , D Palumbo1 , G Peretto1 , S Sala1 , F De Cobelli1 , A Esposito1 , 1San Raffaele Scientific Institute - Milan - Italy ,

On behalf: MIAMI-2013

Citation:
European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii135

BACKGROUND

Acute myocarditis has a highly variable course ranging from complete recovery to end-stage dilated cardiomyopathy, and predictors of outcome are still largely unknown.

 AIM

Aim of the study was to determine the potential value of short-term CMR for the prediction of adverse left ventricle remodeling.

METHOD

From September 2016 to July 2018, 33 consecutive patients with biopsy-proven acute myocarditis underwent baseline CMR (11 ± 8 days after acute clinical presentation) and short-term CMR (65 ± 10 days from baseline MR). Lake-Louise criteria (LL), T1 and T2 mapping were evaluated at each time point, as well as their modification over time. MR parameters were correlated with left ventricle (LV) end-diastolic volume (EDV) and ejection fraction (EF) at short-term CMR.

RESULTS

The vast majority of patients (N = 18,54.5%) presented with infart-like clinical presentation (18,54.5%), followed by 9 (27.3%) with heart failure, 6 (18.2%) with sudden cardiac death/arrhythmia. At baseline CMR, LV volume was 135 ml with EF 53% with a significant elevation of both LL criteria (T2-ratio:2.8, Hyperemia.13%, LGE 6%) and mapping parameters (T1:1103.79, ECV: 31, T2: 53.95) without differences among clinical presentation (p>0.05). At short-term follow-up, a slight recovery of EF was experimented (56%), and all LL and mapping parameters significantly reduced (T2-ratio:2.3, Hyperemia.7%, LGE 4%, T1:1080, ECV: 28, T2: 51), without differences among clinical presentations. Among all parameters analyzed only short-term recovery of T1 mapping was associated to improved LV volume and function (EDV R=0.884, p<0,001, FE%; R= 0,757, p<0,001).

CONCLUSIONS:

Short-term T1 recovery is significantly associated to favorable left ventricle remodeling.



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