ECG features including sum of ST-segment elevation, normalization >24 hours, and negative T wave development independently correlated with larger areas of myocardial damage (P<0.001).
Observational (n=41)
Are specific ECG findings associated with the extent of myocardial damage on cardiac MRI in patients with infarct-like acute myocarditis?
In patients with infarct-like acute myocarditis, specific ECG features such as sum of ST-segment elevation, delayed normalization of STE, and development of negative T waves can help identify those with larger areas of myocardial damage.
Effect estimate: β 0.42-0.49
p-value: p=<0.001
BACKGROUND: Acute myocarditis (AM) may occasionally have an infarct-like presentation. The aim of the present study was to investigate the relation between electrocardiographic (ECG) findings in this group of patients and myocardial damage assessed by cardiac magnetic resonance imaging (MRI) with the late gadolinium enhancement (LGE) technique. HYPOTHESIS: Myocardial damage may be associated with ECG changes in infarct-like AM. METHODS: Forty-one consecutive patients (36 males; mean age, 36 ± 12 years) with diagnosis of AM according to cardiac MRI Lake Louise criteria and infarct-like presentation were included. The relation between site of ST-segment elevation (STE), sum of STE (sumSTE), time to normalization of STE, and development of negative T wave with the extent of LGE (expressed as % of left ventricular mass %LV LGE), was evaluated. RESULTS: Most (80%) patients presented with inferolateral STE; mean sumSTE was 5 ± 3 mm. Normalization of STE occurred within 24 hours in 20 (49%) patients. Development of negative T wave occurred in 28 (68%) patients. Cardiac MRI showed LGE in all patients; mean %LV LGE was 9.6 ± 7.2%. Topographic agreement between site of STE and LGE was 68%. At multivariate analysis, sumSTE (β = 0.42, P 24 hours (β = 0.39, P 24 hours, and development of negative T wave) may help to identify patients with larger areas of myocardial damage.
Nucifora et al. (Mon,) conducted a observational in Acute myocarditis with infarct-like presentation (n=41). Electrocardiographic findings (sumSTE, normalization >24 hours, negative T wave) was evaluated on Extent of late gadolinium enhancement (%LV LGE) (β 0.42-0.49, p=<0.001). ECG features including sum of ST-segment elevation, normalization >24 hours, and negative T wave development independently correlated with larger areas of myocardial damage (P<0.001).
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