Prognostic Significance of Cardiac Magnetic Resonance in Left Atrial and Biventricular Strain Analysis during the Follow-Up of Suspected Myocarditis

Figure 1. Representative example of left atrial and biventricular strain analysis. 2-, 3-, and 4-chamber view long-axis (a–c) and short-axis ((e–g), from bottom to apex) cine images were used for ventricular strain analysis. The endo- and epicardial borders of both ventricles were depicted, red and green lines in picture (a–c,e–g) refer to LV endo- and epicardial borders, respectively; yellow and blue lines in picture (c,e–g) refer to RV endo- and epicardial borders, respectively; and the curves of peak global longitudinal of LV (d) and RV (h) were automatically constructed. 2- and 4-chamber view long-axis (i,j) cine images were used for left atrial strain analysis. The endo- (red lines) and epicardial (green lines) borders of the LA were manually depicted, and the curves of peak strain (k) and strain rate (l) of the LA were automatically constructed.

Figure 2. Baseline and 3-month follow-up T2 STIR and LGE images of a 15-year-old man with acute myocarditis. Myocardial edema in the basal ventricular segment of septal wall resolved from baseline ((A), yellow arrows) to follow-up ((C), red arrows). However, the LGE persisted (B,D).

Figure 3. Differences in the left atrial and biventricular function and myocardial strain between baseline and follow-up period. LAEF was the only significantly recovered functional parameter. The absolute value of LVGLS, RVGRS, LA εs, εe, and SRa was significantly increased.