Key result
Cardiac magnetic resonance feature tracking demonstrated that global longitudinal strain and global circumferential strain were significantly impaired in patients with suspected acute myocarditis compared to healthy controls.
Why the study?
Although CMR-FT enables quantitative assessment of global myocardial strain in suspected acute myocarditis, cardiac segmental dysfunction remains understudied.
Does cardiac magnetic resonance feature tracking (CMR-FT) improve the diagnosis and assessment of myocardial injury severity in patients with suspected acute myocarditis?
Case-Control (n=86)
Single-blind
No
Does cardiac magnetic resonance feature tracking (CMR-FT) improve the diagnosis and assessment of myocardial injury severity in patients with suspected acute myocarditis?
CMR feature tracking identifies impaired global and segmental myocardial strain in suspected acute myocarditis, even in regions without overt edema or late gadolinium enhancement, providing incremental diagnostic value.
Answers are grounded in this paper and cite their sources.
CMR-FT may add incremental diagnostic value in suspected myocarditis; leaves open whether it improves outcomes or should change practice.
Background Albeit that cardiac magnetic resonance feature tracking (CMR-FT) has enabled quantitative assessment of global myocardial strain in the diagnosis of suspected acute myocarditis, the cardiac segmental dysfunction remains understudied. The aim of the present study was using CMR-FT to assess the global and segmental dysfunction of the myocardium for diagnosis of suspected acute myocarditis. Methods Forty-seven patients with suspected acute myocarditis (divided into impaired and preserved left ventricular ejection fraction [LVEF] groups) and 39 healthy controls (HCs) were studied. A total of 752 segments were divided into three subgroups, including segments with non-involvement (S Ni ), segments with edema (S E ), and segments with both edema and late gadolinium enhancement (S E+LGE ). 272 healthy segments served as the control group (S HCs ). Results Compared with HCs, patients with preserved LVEF showed impaired global circumferential strain (GCS) and global longitudinal strain (GLS). Segmental strain analysis showed that the peak radial strain (PRS), peak circumferential strain (PCS), and peak longitudinal strain (PLS) values significantly reduced in S E+LGE compared with S HCs , S Ni , S E . PCS significantly reduced in S Ni (-15.3 ± 5.8% vs. -20.3 ± 6.4%, p < 0.001) and S E (-15.2 ± 5.6% vs. -20.3 ± 6.4%, p < 0.001), compared with S HCs . The area under the curve (AUC) values of GLS (0.723) and GCS (0.710) were higher than that of global peak radial strain (0.657) in the diagnosis of acute myocarditis, but the difference was not statistically significant. Adding the Lake Louise Criteria to the model resulted in a further increase in diagnostic performance. Conclusions Global and segmental myocardial strain were impaired in patients with suspected acute myocarditis, even in the edema or relatively non-involved regions. CMR-FT may serve as an incremental tool for assessment of cardiac dysfunction and provide important additional imaging-evidence for distinguishing the different severity of myocardial injury in myocarditis.
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Gao et al. (2023) conducted a case-control in Suspected acute myocarditis (n=86). Cardiac magnetic resonance feature tracking (CMR-FT) vs. Healthy controls was evaluated on Global longitudinal strain (GLS) (p=<0.001). Cardiac magnetic resonance feature tracking demonstrated that global longitudinal strain and global circumferential strain were significantly impaired in patients with suspected acute myocarditis compared to healthy controls.
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