Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis
According to updated Lake-Louise Criteria, impaired regional myocardial function serves as a supportive criterion in diagnosing myocarditis. This study aimed to assess visual regional wall motional abnormalities (RWMA) and novel quantitative regional longitudinal peak strain (RLS) for risk stratific...
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| Veröffentlicht in: | The international journal of cardiovascular imaging 2024-04, Vol.40 (4), p.907-920 |
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| creator | Bernhard, Benedikt Joss, Philippe Greisser, Noah Stark, Anselm W. Schütze, Jonathan Shiri, Isaac Safarkhanlo, Yasaman Fischer, Kady Guensch, Dominik P. Bastiaansen, Jessica A. M. Pavlicek, Maryam Benz, Dominik C. Kwong, Raymond Y. Gräni, Christoph |
| description | According to updated Lake-Louise Criteria, impaired regional myocardial function serves as a supportive criterion in diagnosing myocarditis. This study aimed to assess visual regional wall motional abnormalities (RWMA) and novel quantitative regional longitudinal peak strain (RLS) for risk stratification in the clinical setting of myocarditis. In patients undergoing CMR and meeting clinical criteria for suspected myocarditis global longitudinal strain (GLS), late gadolinium enhancement (LGE), RWMA and RLS were assessed in the anterior, septal, inferior, and lateral regions and correlated to the occurrence of major adverse cardiac events (MACE), including heart failure hospitalization, sustained ventricular tachycardia, recurrent myocarditis, and all-cause death. In 690 consecutive patients (age: 48.0 ± 16.0 years; 37.7% female) with suspected myocarditis impaired RLS was correlated with RWMA and LV-GLS but not with the presence of LGE. At median follow up of 3.8 years, MACE occurred in 116 (16.8%) patients. Both, RWMA and RLS in anterior-, septal-, inferior-, and lateral- locations were univariately associated with outcomes (all p |
| doi_str_mv | 10.1007/s10554-024-03059-1 |
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adjusted
= 1.132, 95% CI 1.020–1.256; p = 0.020). RWMA and RLS can be used to assess regional impairment of myocardial function in myocarditis but are of limited prognostic value in the overall population. However, in the subgroup of patients with normal LV function, septal RLS represents a distinctive marker of regional LV dysfunction, offering potential for risk-stratification.
Graphical abstract
CI: confidence interval, CMR: cardiac magnetic resonance imaging, HR: hazard ratio, MACE major adverse cardiovascular events</description><identifier>ISSN: 1875-8312</identifier><identifier>ISSN: 1569-5794</identifier><identifier>EISSN: 1875-8312</identifier><identifier>EISSN: 1573-0743</identifier><identifier>DOI: 10.1007/s10554-024-03059-1</identifier><identifier>PMID: 38427272</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Abnormalities ; Cardiac Imaging ; Cardiology ; Confidence intervals ; Congestive heart failure ; Criteria ; Gadolinium ; Heart diseases ; Imaging ; Magnetic resonance imaging ; Medicine ; Medicine & Public Health ; Myocarditis ; Original Paper ; Radiology ; Regional analysis ; Subgroups ; Tachycardia</subject><ispartof>The international journal of cardiovascular imaging, 2024-04, Vol.40 (4), p.907-920</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-28ebe70129020deb4a093ae0f169ebeaba3030fa1c26ef6927627707489712e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10554-024-03059-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10554-024-03059-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38427272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernhard, Benedikt</creatorcontrib><creatorcontrib>Joss, Philippe</creatorcontrib><creatorcontrib>Greisser, Noah</creatorcontrib><creatorcontrib>Stark, Anselm W.</creatorcontrib><creatorcontrib>Schütze, Jonathan</creatorcontrib><creatorcontrib>Shiri, Isaac</creatorcontrib><creatorcontrib>Safarkhanlo, Yasaman</creatorcontrib><creatorcontrib>Fischer, Kady</creatorcontrib><creatorcontrib>Guensch, Dominik P.</creatorcontrib><creatorcontrib>Bastiaansen, Jessica A. M.</creatorcontrib><creatorcontrib>Pavlicek, Maryam</creatorcontrib><creatorcontrib>Benz, Dominik C.</creatorcontrib><creatorcontrib>Kwong, Raymond Y.</creatorcontrib><creatorcontrib>Gräni, Christoph</creatorcontrib><title>Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis</title><title>The international journal of cardiovascular imaging</title><addtitle>Int J Cardiovasc Imaging</addtitle><addtitle>Int J Cardiovasc Imaging</addtitle><description>According to updated Lake-Louise Criteria, impaired regional myocardial function serves as a supportive criterion in diagnosing myocarditis. This study aimed to assess visual regional wall motional abnormalities (RWMA) and novel quantitative regional longitudinal peak strain (RLS) for risk stratification in the clinical setting of myocarditis. In patients undergoing CMR and meeting clinical criteria for suspected myocarditis global longitudinal strain (GLS), late gadolinium enhancement (LGE), RWMA and RLS were assessed in the anterior, septal, inferior, and lateral regions and correlated to the occurrence of major adverse cardiac events (MACE), including heart failure hospitalization, sustained ventricular tachycardia, recurrent myocarditis, and all-cause death. In 690 consecutive patients (age: 48.0 ± 16.0 years; 37.7% female) with suspected myocarditis impaired RLS was correlated with RWMA and LV-GLS but not with the presence of LGE. At median follow up of 3.8 years, MACE occurred in 116 (16.8%) patients. Both, RWMA and RLS in anterior-, septal-, inferior-, and lateral- locations were univariately associated with outcomes (all p < 0.001), but not after adjusting for clinical characteristics and LV-GLS. In the subgroup of patients with normal LV function, RWMA were not predictive of outcomes, whereas septal RLS had incremental and independent prognostic value over clinical characteristics (HR
adjusted
= 1.132, 95% CI 1.020–1.256; p = 0.020). RWMA and RLS can be used to assess regional impairment of myocardial function in myocarditis but are of limited prognostic value in the overall population. However, in the subgroup of patients with normal LV function, septal RLS represents a distinctive marker of regional LV dysfunction, offering potential for risk-stratification.
Graphical abstract
CI: confidence interval, CMR: cardiac magnetic resonance imaging, HR: hazard ratio, MACE major adverse cardiovascular events</description><subject>Abnormalities</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Criteria</subject><subject>Gadolinium</subject><subject>Heart diseases</subject><subject>Imaging</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myocarditis</subject><subject>Original Paper</subject><subject>Radiology</subject><subject>Regional analysis</subject><subject>Subgroups</subject><subject>Tachycardia</subject><issn>1875-8312</issn><issn>1569-5794</issn><issn>1875-8312</issn><issn>1573-0743</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9UU2PFCEQJUbjrqN_wIMh8eKltYCepvtkzMSvZI3G6JkwdPUsmx6YpWDM_nsZZx1XD4YQKrzHo-o9xp4KeCkA9CsSsFy2Dci6FSyHRtxj56LXy6ZXQt6_U5-xR0RXAEKrYXjIzlTfSl3XOaMvKW5CpOwd39u5II8T33sqduY2jPy62JB9ttnvka8-feUJNz6Gim5vorNp9LWcSnC53nIf-K5SMWTiP3y-5FRohy7jeKJnT4_Zg8nOhE9uzwX7_u7tt9WH5uLz-4-rNxeNa2WXG9njGjUIOYCEEdethUFZhEl0Q0Xs2qo69mSFkx1O3SB1J7UG3faDFhKlWrDXR91dWW9xdLWtZGezS35r042J1pu_keAvzSbujajGSi1EVXhxq5DidUHKZuvJ4TzbgLGQkYOqRrZQzwV7_g_1KpZUjSKjoNUA1fkDSx5ZLkWihNOpGwHmEKo5hmpqqOZXqObQxbO7c5ye_E6xEtSRQBUKG0x__v6P7E8Efq9H</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Bernhard, Benedikt</creator><creator>Joss, Philippe</creator><creator>Greisser, Noah</creator><creator>Stark, Anselm W.</creator><creator>Schütze, Jonathan</creator><creator>Shiri, Isaac</creator><creator>Safarkhanlo, Yasaman</creator><creator>Fischer, Kady</creator><creator>Guensch, Dominik P.</creator><creator>Bastiaansen, Jessica A. M.</creator><creator>Pavlicek, Maryam</creator><creator>Benz, Dominik C.</creator><creator>Kwong, Raymond Y.</creator><creator>Gräni, Christoph</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240401</creationdate><title>Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis</title><author>Bernhard, Benedikt ; Joss, Philippe ; Greisser, Noah ; Stark, Anselm W. ; Schütze, Jonathan ; Shiri, Isaac ; Safarkhanlo, Yasaman ; Fischer, Kady ; Guensch, Dominik P. ; Bastiaansen, Jessica A. 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M.</creatorcontrib><creatorcontrib>Pavlicek, Maryam</creatorcontrib><creatorcontrib>Benz, Dominik C.</creatorcontrib><creatorcontrib>Kwong, Raymond Y.</creatorcontrib><creatorcontrib>Gräni, Christoph</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The international journal of cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernhard, Benedikt</au><au>Joss, Philippe</au><au>Greisser, Noah</au><au>Stark, Anselm W.</au><au>Schütze, Jonathan</au><au>Shiri, Isaac</au><au>Safarkhanlo, Yasaman</au><au>Fischer, Kady</au><au>Guensch, Dominik P.</au><au>Bastiaansen, Jessica A. M.</au><au>Pavlicek, Maryam</au><au>Benz, Dominik C.</au><au>Kwong, Raymond Y.</au><au>Gräni, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis</atitle><jtitle>The international journal of cardiovascular imaging</jtitle><stitle>Int J Cardiovasc Imaging</stitle><addtitle>Int J Cardiovasc Imaging</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>40</volume><issue>4</issue><spage>907</spage><epage>920</epage><pages>907-920</pages><issn>1875-8312</issn><issn>1569-5794</issn><eissn>1875-8312</eissn><eissn>1573-0743</eissn><abstract>According to updated Lake-Louise Criteria, impaired regional myocardial function serves as a supportive criterion in diagnosing myocarditis. This study aimed to assess visual regional wall motional abnormalities (RWMA) and novel quantitative regional longitudinal peak strain (RLS) for risk stratification in the clinical setting of myocarditis. In patients undergoing CMR and meeting clinical criteria for suspected myocarditis global longitudinal strain (GLS), late gadolinium enhancement (LGE), RWMA and RLS were assessed in the anterior, septal, inferior, and lateral regions and correlated to the occurrence of major adverse cardiac events (MACE), including heart failure hospitalization, sustained ventricular tachycardia, recurrent myocarditis, and all-cause death. In 690 consecutive patients (age: 48.0 ± 16.0 years; 37.7% female) with suspected myocarditis impaired RLS was correlated with RWMA and LV-GLS but not with the presence of LGE. At median follow up of 3.8 years, MACE occurred in 116 (16.8%) patients. Both, RWMA and RLS in anterior-, septal-, inferior-, and lateral- locations were univariately associated with outcomes (all p < 0.001), but not after adjusting for clinical characteristics and LV-GLS. In the subgroup of patients with normal LV function, RWMA were not predictive of outcomes, whereas septal RLS had incremental and independent prognostic value over clinical characteristics (HR
adjusted
= 1.132, 95% CI 1.020–1.256; p = 0.020). RWMA and RLS can be used to assess regional impairment of myocardial function in myocarditis but are of limited prognostic value in the overall population. However, in the subgroup of patients with normal LV function, septal RLS represents a distinctive marker of regional LV dysfunction, offering potential for risk-stratification.
Graphical abstract
CI: confidence interval, CMR: cardiac magnetic resonance imaging, HR: hazard ratio, MACE major adverse cardiovascular events</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>38427272</pmid><doi>10.1007/s10554-024-03059-1</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abnormalities Cardiac Imaging Cardiology Confidence intervals Congestive heart failure Criteria Gadolinium Heart diseases Imaging Magnetic resonance imaging Medicine Medicine & Public Health Myocarditis Original Paper Radiology Regional analysis Subgroups Tachycardia |
| title | Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis |
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