Key result
In patients with acute perimyocarditis, regional wall motion abnormalities predominantly involved the infero-postero-lateral segments (52 of 69 patients with abnormalities), with no mortality observed over 37 months.
Observational (n=100)
No
Conventional echocardiography frequently detects regional wall motion abnormalities in the infero-postero-lateral segments in patients with acute perimyocarditis, a condition associated with a benign long-term mortality outcome despite frequent recurrences.
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May aid echocardiographic diagnosis of acute perimyocarditis via infero-postero-lateral wall motion abnormalities; leaves open prognostic value beyond this cohort.
BACKGROUND: Until recently acute inflammatory peri-myocardial syndromes have been associated with global rather regional left ventricular (LV) dysfunction. Recent advances in cardiac imaging with echocardiographic techniques and magnetic resonance imaging (MRI) permit comprehensive evaluation of global and regional LV function. Our study was aimed to assess regional LV function in 100 patients with acute perimyocarditis, and correlate these findings with the clinical presentation. METHODS: We report on 100 patients with acute perimyocarditis admitted during 2008-2011, in whom LV function was assessed by semi-quantitative wall motion score analysis on conventional echo. Long-term mortality and recurrent hospitalization were also assessed. RESULTS: Wall motion score in 100 patients with acute perimyocarditis demonstrated a significant predominance of regional wall motion abnormalities in the infero-postero-lateral LV wall. These data correspond well with speckle tracking results of a subgroup of these patients published earlier. Recent MRI data show frequent late enhancement of contrast in the infero-lateral region of the LV in patients with perimyocarditis. These observations were useful in re-classification of our patients into one of the following groups: pure or predominant pericarditis, and pure or predominant myocarditis. Over a mean period of 37 months, there was no mortality. Though recurrent hospitalizations were rather frequent, no significant differences were observed among groups. CONCLUSIONS: Regional wall motion abnormalities in the infero-postero-lateral segments of the LV are frequent in patients with acute perimyocarditis. Detailed echocardiographic examination early in the course of the disease should become a major factor in the clinical differentiation among the various clinical presentations of acute inflammatory peri-myocardial syndromes. The long-term outcome of these patients appears to be benign, though recurrent hospitalizations are not infrequent.
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Leitman et al. (2012) conducted an observational in Acute inflammatory peri-myocardial diseases (n=100). Acute inflammatory peri-myocardial diseases was evaluated on Regional wall motion abnormalities and long-term mortality. In patients with acute perimyocarditis, regional wall motion abnormalities predominantly involved the infero-postero-lateral segments (52 of 69 patients with abnormalities), with no mortality observed over 37 months.
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