S Bohnen1, U K Radunski1, G K Lund2, F Ojeda1, Y Looft1, M Senel1, L Radziwolek1, M Avanesov2, E Tahir2, C Stehning3, B Schnackenburg4, G Adam2, S Blankenberg1, K Muellerleile1. 1. Department of General and Interventional Cardiology, General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, University Heart Center, Martinistrasse 52, 20246 Hamburg, Germany. 2. Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg. 3. Philips GmbH Market DACH, Roentgenstr. 22, 22335 Hamburg. 4. Philips GmbH Market DACH, Luebeckertordamm 5, 20099 Hamburg.
Abstract
AIMS: Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. METHODS AND RESULTS: Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. CONCLUSION: Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Monitoring disease activity in myocarditis is important for tailored therapeutic strategies. This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance (CMR) to monitor the course of myocardial inflammation in healing myocarditis. METHODS AND RESULTS: Forty-eight patients with strictly defined acute myocarditis underwent CMR at 1.5 T in the acute stage, at 3-months (n = 39), and at 12-months follow-up (FU) (n = 21). Normal values were obtained in a control group of 27 healthy subjects. The CMR protocol included standard ('Lake-Louise') sequences as well as T1 (modified Look-Locker inversion recovery sequence, MOLLI) and T2 (gradient- and spin-echo sequence, GraSE) mapping. T1, T2, and extracellular volume (ECV) maps were generated using an OsiriX plug-in. Native myocardial T1, T2, and ECV values were increased in the acute stage, but declined with healing of myocarditis. The performances of global native T1 and T2 to differentiate acute from healed myocarditis stages were significantly better compared with all other global CMR parameters with AUCs of 0.85 (95% CI, 0.76-0.94) and 0.83 (95% CI, 0.73-0.93). Furthermore, regional native T1 and T2 in myocarditis lesions provided AUCs of 0.97 (95% CI, 0.93-1.02) and 0.93 (95% CI, 0.85-1.01), which were significantly superior to any other global or regional CMR parameter. CONCLUSION: Healing of myocarditis can be monitored by native myocardial T1 and T2 measurements without the need for contrast media. Both native myocardial T1 and T2 provide an excellent performance for assessing the stage of myocarditis by CMR. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Dina Radenkovic; Sebastian Weingärtner; Lewis Ricketts; James C Moon; Gabriella Captur Journal: Heart Fail Rev Date: 2017-07 Impact factor: 4.214
Authors: G J H Snel; M van den Boomen; L M Hernandez; C T Nguyen; D E Sosnovik; B K Velthuis; R H J A Slart; R J H Borra; N H J Prakken Journal: J Cardiovasc Magn Reson Date: 2020-05-11 Impact factor: 5.364