OBJECTIVES: To evaluate myocarditis in a pediatric population using cardiovascular magnetic resonance (CMR) and endomyocardial biopsy. METHODS: Twenty suspected for myocarditis patients aged 8-16 years and 20 controls were evaluated. CMR was performed using STIR T2-weighted (T2W), early T1-weighted (EGE) and late gadolinium-enhanced images (LGE). Immunohistologic and polymerase chain reaction (PCR) analysis of myocardial specimens were employed in 8/16, who fulfilled the criteria for myocarditis according to clinical and CMR findings. RESULTS: Typical clinical, ECG and echocardiographic presentation were identified in 10/16. Troponine I was positive only in 3/16 patients. T2 and EGE in myocarditis were increased compared to controls (2.35 ± 0.5 vs. 1.57 ± 0.13, p<0.001 and 8.5 ± 3 vs. 3.59 ± 0.08, p<0.001, respectively). LGE was found only in 10/16 patients. Endomyocardial biopsy, performed in 8/16 patients with positive CMR, showed positive immunohistology in 2/8 and presence of viral genomes in 6/8 (Herpes, Parvo B19 and Epstein-Barr). Left ventricular ejection fraction (LVEF) was significantly decreased compared to controls (49.6 ± 14.8 vs. 64 ± 0.2, p<0.001). After 6 months, CMR showed normalization of T2, EGE and decreased/or absent LGE. LVEF was normal in all, except two, who remained with low LVEF but in a stable clinical condition. CONCLUSIONS: In a small Greek pediatric population with myocarditis, CMR proved useful for the detection of myocarditis, especially in those with negative troponine and mild clinical presentation.
OBJECTIVES: To evaluate myocarditis in a pediatric population using cardiovascular magnetic resonance (CMR) and endomyocardial biopsy. METHODS: Twenty suspected for myocarditispatients aged 8-16 years and 20 controls were evaluated. CMR was performed using STIR T2-weighted (T2W), early T1-weighted (EGE) and late gadolinium-enhanced images (LGE). Immunohistologic and polymerase chain reaction (PCR) analysis of myocardial specimens were employed in 8/16, who fulfilled the criteria for myocarditis according to clinical and CMR findings. RESULTS: Typical clinical, ECG and echocardiographic presentation were identified in 10/16. Troponine I was positive only in 3/16 patients. T2 and EGE in myocarditis were increased compared to controls (2.35 ± 0.5 vs. 1.57 ± 0.13, p<0.001 and 8.5 ± 3 vs. 3.59 ± 0.08, p<0.001, respectively). LGE was found only in 10/16 patients. Endomyocardial biopsy, performed in 8/16 patients with positive CMR, showed positive immunohistology in 2/8 and presence of viral genomes in 6/8 (Herpes, Parvo B19 and Epstein-Barr). Left ventricular ejection fraction (LVEF) was significantly decreased compared to controls (49.6 ± 14.8 vs. 64 ± 0.2, p<0.001). After 6 months, CMR showed normalization of T2, EGE and decreased/or absent LGE. LVEF was normal in all, except two, who remained with low LVEF but in a stable clinical condition. CONCLUSIONS: In a small Greek pediatric population with myocarditis, CMR proved useful for the detection of myocarditis, especially in those with negative troponine and mild clinical presentation.
Authors: Teresa M Lee; Daphne T Hsu; Paul Kantor; Jeffrey A Towbin; Stephanie M Ware; Steven D Colan; Wendy K Chung; John L Jefferies; Joseph W Rossano; Chesney D Castleberry; Linda J Addonizio; Ashwin K Lal; Jacqueline M Lamour; Erin M Miller; Philip T Thrush; Jason D Czachor; Hiedy Razoky; Ashley Hill; Steven E Lipshultz Journal: Circ Res Date: 2017-09-15 Impact factor: 17.367
Authors: Mark J Cartoski; Plamen P Nikolov; Adityo Prakosa; Patrick M Boyle; Philip J Spevak; Natalia A Trayanova Journal: Pediatr Cardiol Date: 2019-03-06 Impact factor: 1.655
Authors: Puja Banka; Joshua D Robinson; Santosh C Uppu; Matthew A Harris; Keren Hasbani; Wyman W Lai; Marc E Richmond; Sohrab Fratz; Supriya Jain; Tiffanie R Johnson; Shiraz A Maskatia; Jimmy C Lu; Margaret M Samyn; David Patton; Andrew J Powell Journal: J Cardiovasc Magn Reson Date: 2015-11-17 Impact factor: 5.364