Francesca Raimondi1, Franck Iserin1, Olivier Raisky1, Daniela Laux1, Fanny Bajolle1, Younes Boudjemline1, Nathalie Boddaert2, Damien Bonnet3. 1. Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France. 2. Radiology Department, Université Paris Descartes, Paris, France. 3. Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France damien.bonnet@nck.aphp.fr damien.bonnet1@gmail.com.
Abstract
AIMS: To analyse the predictive role of myocardial inflammation assessed by cardiac magnetic resonance (CMR) on the outcome of recently diagnosed dilated cardiomyopathy in children. METHODS AND RESULTS: Over a period of 4 years, 66 children underwent CMR within 2 weeks after the diagnosis of dilated cardiomyopathy. CMR sequences sensitive for oedema, hyperaemia, and irreversible injury were applied: unenhanced cine steady-state free precession (SSFP), black-blood-prepared T1-weighted images, T2-weighted images, gadolinium-enhanced T1-weighted images (EGE), and late gadolinium-enhanced (LGE) images. Inflammatory cardiomyopathy defined as the presence of at least two CMR criteria was diagnosed in 31/66 children (CMR positive) while no criterion was present in the remaining 33 (CMR-negative). Only two patients had one positive criterion and were excluded from subsequent analysis. After a mean follow-up of 24 months, LV function recovery (LV ejection fraction >55%) was more frequent in the CMR-positive group (24 vs. 11, P < 0.05). The presence of myocardial inflammation and elevated troponin levels at baseline were the two predictors of LV function recovery with an odds ratio of 3.76 (P = 0.02) and 2.76 (P = 0.03), respectively, in a logistic regression model. Persisting LGE was rare in patients of the CMR-positive group at control CMR (6/22) and was never observed in the CMR-negative group (0/16). CONCLUSION: The presence of myocardial inflammation on CMR at time of diagnosis of a dilated cardiomyopathy in children is a strong predictor of LV recovery. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To analyse the predictive role of myocardial inflammation assessed by cardiac magnetic resonance (CMR) on the outcome of recently diagnosed dilated cardiomyopathy in children. METHODS AND RESULTS: Over a period of 4 years, 66 children underwent CMR within 2 weeks after the diagnosis of dilated cardiomyopathy. CMR sequences sensitive for oedema, hyperaemia, and irreversible injury were applied: unenhanced cine steady-state free precession (SSFP), black-blood-prepared T1-weighted images, T2-weighted images, gadolinium-enhanced T1-weighted images (EGE), and late gadolinium-enhanced (LGE) images. Inflammatory cardiomyopathy defined as the presence of at least two CMR criteria was diagnosed in 31/66 children (CMR positive) while no criterion was present in the remaining 33 (CMR-negative). Only two patients had one positive criterion and were excluded from subsequent analysis. After a mean follow-up of 24 months, LV function recovery (LV ejection fraction >55%) was more frequent in the CMR-positive group (24 vs. 11, P < 0.05). The presence of myocardial inflammation and elevated troponin levels at baseline were the two predictors of LV function recovery with an odds ratio of 3.76 (P = 0.02) and 2.76 (P = 0.03), respectively, in a logistic regression model. Persisting LGE was rare in patients of the CMR-positive group at control CMR (6/22) and was never observed in the CMR-negative group (0/16). CONCLUSION: The presence of myocardial inflammation on CMR at time of diagnosis of a dilated cardiomyopathy in children is a strong predictor of LV recovery. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Adam L Dorfman; Tal Geva; Margaret M Samyn; Gerald Greil; Rajesh Krishnamurthy; Daniel Messroghli; Pierluigi Festa; Aurelio Secinaro; Brian Soriano; Andrew Taylor; Michael D Taylor; René M Botnar; Wyman W Lai Journal: J Cardiovasc Magn Reson Date: 2022-07-21 Impact factor: 6.903