Key result
3D global longitudinal strain demonstrated significant diagnostic performance for acute myocarditis with an AUC of 0.826, outperforming conventional echocardiographic parameters.
Why the study?
The diagnostic importance of 3D speckle-tracking strain-imaging echocardiography in patients with acute myocarditis remains unclear.
Does 3D-speckle-tracking echocardiography correlate with CMR for the diagnosis of acute myocarditis in patients with clinically suspected myocarditis?
Observational (n=45)
Single-blind
No
Does 3D-speckle-tracking echocardiography correlate with CMR for the diagnosis of acute myocarditis in patients with clinically suspected myocarditis?
Effect estimate: AUC 0.826 (95% CI 0.62-0.95)
Absolute Event Rate: 0.826% vs 0.771%
p-value: p=0.0003
3D-speckle-tracking echocardiography, particularly global longitudinal strain, correlates well with CMR findings and may serve as a useful primary diagnostic tool for acute myocarditis.
3D speckle-tracking echocardiography was associated with CMR findings in suspected myocarditis; leaves open its diagnostic role pending larger prospective studies.
Background: The diagnostic importance of three-dimensional (3D) speckle-tracking strain-imaging echocardiography in patients with acute myocarditis remains unclear. The aim of this study was to test the diagnostic performance of 3D-speckle-tracking echocardiography compared to CMR (cardiovascular magnetic resonance imaging) for the diagnosis of acute myocarditis. Methods and results: 45 patients with clinically suspected myocarditis were enrolled in our study (29% female, mean age: 43.9 ± 16.3 years, peak troponin I level: 1.38 ± 3.51 ng/ml). 3D full-volume echocardiographic images were obtained and offline 2D as well as 3D speckle-tracking analysis of regional and global LV deformation was performed. All patients received CMR scans and myocarditis was diagnosed in 29 subjects based on original Lake-Louise criteria. The 16 patients, in whom myocarditis was excluded by CMR, served as controls. Regional changes in myocardial texture (diagnosed by CMR) were significantly associated with regional impairment of circumferential, longitudinal, and radial strain, as well as regional 3D displacement and total 3D strain. Interestingly, the 2D and 3D global longitudinal strain (GLS) showed higher diagnostic performance than well-known parameters associated with myocarditis, such as LVEF (as obtained by echocardiography and CMR) and LVEDV (as obtained by CMR). Conclusions: In this study, we examined the use of 3D-speckle-tracking echocardiography in patients with acute myocarditis. Global longitudinal strain was significantly impaired in patients with acute myocarditis and correlated with CMR findings. Therefore, 3D echocardiography could become a useful diagnostic tool in the primary diagnosis of myocarditis.
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Goody et al. (2022) conducted an observational in Acute myocarditis (n=45). 3D-speckle-tracking echocardiography (3D global longitudinal strain) vs. 2D global longitudinal strain was evaluated on Diagnostic performance (Area Under the Curve) for acute myocarditis compared to CMR (AUC 0.826, 95% CI 0.62-0.95, p=0.0003). 3D global longitudinal strain demonstrated significant diagnostic performance for acute myocarditis with an AUC of 0.826, outperforming conventional echocardiographic parameters.
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