Key result
Older age was the only predictor of persistent inflammatory changes on follow-up CMR, which occurred in 29% of pediatric patients with acute myocarditis at a median of 6 months.
Why the study?
To assess the frequency of persistent inflammation at follow-up CMR and identify predictors of ongoing active changes in children with acute myocarditis.
Observational (n=31)
Follow-up CMR reveals persistent active inflammatory changes in nearly 30% of pediatric myocarditis patients at 6 months, exclusively among older adolescents (14-17 years).
Answers are grounded in this paper and cite their sources.
Persistent inflammation on follow-up CMR in 29% of children, especially older adolescents; leaves open need for prospective validation before guiding practice.
Background/Objectives: Cardiac magnetic resonance (CMR) is used to diagnose and monitor the course of acute myocarditis in adults and children. This study aimed to assess the frequency of persistent inflammation at follow-up CMR and to look for predictors of ongoing active changes in CMR in children with myocarditis. Methods: This retrospective study included 31 children (median age 15 years, 68% male) with clinically and CMR-diagnosed acute myocarditis who underwent baseline and follow-up CMR at a median of 6 months. Old and new Lake Louise criteria were compared. Results: A complete resolution of changes was observed in four patients (13%) at follow-up, according to both criteria. Seven patients (23%) presented ongoing active changes, and twenty (64%) showed a persistent scar according to the old Lake Louise criteria. When the new Lake Louise criteria were used, an additional two patients (6%) were found to have persistent active changes instead of a persistent scar. Patients with persistent inflammation (nine patients, 29%) were older than those who showed recovery. None of the patients below 14 years of age presented active changes on their follow-up CMR and all the patients who showed inflammation were between 14 and 17 years old. Conclusions: Pediatric myocarditis can lead to persistent active changes in CMR beyond a 6-month follow-up in over a fifth of patients. The application of new Lake Louise criteria further increases that number compared to the old criteria. The only predictor of persistent inflammatory changes in CMR is older age.
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Małek et al. (2024) conducted an observational in Acute myocarditis (n=31). Older age (14-17 years) vs. Younger age (<14 years) was evaluated on Persistent inflammation at follow-up CMR. Older age was the only predictor of persistent inflammatory changes on follow-up CMR, which occurred in 29% of pediatric patients with acute myocarditis at a median of 6 months.
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