Elevated global T2 time at initial presentation significantly predicted the occurrence of major adverse cardiac events and heart failure hospitalization in patients with suspected acute myocarditis (OR 6.3).
Observational (n=106)
No
Does elevated T2 mapping on cardiovascular magnetic resonance predict major adverse cardiac events and heart failure hospitalization in patients with suspected acute myocarditis?
Elevated myocardial T2 relaxation times on initial CMR independently predict adverse clinical outcomes in patients with suspected acute myocarditis, facilitating early risk stratification.
Effect estimate: OR 6.3 (95% CI 1.2-24.9)
p-value: p=<0.02
BACKGROUND: While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to increase diagnostic accuracy. However, prognostic implications of T2 values in this cohort are unknown. The purpose of the study was to investigate the prognostic relevance of elevated CMR T2 values in patients with sAMC. METHODS AND RESULTS: We carried out a prospective study in 46 patients with sAMC defined by current ESC recommendations. A combined endpoint was defined by the occurrence of at least one major adverse cardiac event (MACE) and hospitalisation for heart failure. Event rate was 24% (n = 11) for 1-year-MACE and hospitalisation. A follow-up after 11 ± 7 months was performed in 98% of the patients. Global T2 values were significantly increased at acute stage of disease compared to controls and decreased over time. During acute disease, elevated global T2 time (odds ratio 6.3, p 80 ms (odds ratio 4.9, p < 0.04) predicted occurrence of the combined endpoint. Patients with clinical recovery revealed significantly decreased T2 relaxation times at follow-up examinations; however, T2 values were still elevated compared to healthy controls. CONCLUSION: Assessment of myocardial T2 relaxation times at initial presentation facilitates CMR-based risk stratification in patients with acute myocarditis. T2 Mapping may emerge as a new tool to monitor inflammatory myocardial injuries during the course of disease.
Spieker et al. (Thu,) conducted a observational in Suspected acute myocarditis (n=106). Elevated global T2 time (>4 SD) vs. Normal T2 time was evaluated on Composite of major adverse cardiac events (MACE) and hospitalisation due to heart failure (OR 6.3, 95% CI 1.2-24.9, p=<0.02). Elevated global T2 time at initial presentation significantly predicted the occurrence of major adverse cardiac events and heart failure hospitalization in patients with suspected acute myocarditis (OR 6.3).