Giovanni Donato Aquaro1, Matteo Perfetti2, Giovanni Camastra3, Lorenzo Monti4, Santo Dellegrottaglie5, Claudio Moro6, Alessia Pepe2, Giancarlo Todiere2, Chiara Lanzillo7, Alessandra Scatteia8, Mauro Di Roma9, Gianluca Pontone10, Martina Perazzolo Marra11, Andrea Barison2, Gianluca Di Bella12. 1. Gabriele Monasterio Foundation, Tuscan Region, Pisa, Italy. Electronic address: aquaro@ftgm.it. 2. Gabriele Monasterio Foundation, Tuscan Region, Pisa, Italy. 3. Cardiac Department, Vannini Hospital Rome, Rome, Italy. 4. Radiology Department, Humanitas Research Hospital, Hospital Care and Research Institution (IRCCS), Rozzano, Milan, Italy. 5. Division of Cardiology, Villa dei Fiori, Acerra, Naples, Italy; Mount Sinai School of Medicine, New York, New York. 6. Department of Cardiology and Coronary Intensive CareUnit, ASST Monza, Desio Hospital, Desio Monza e Brianza, Italy. 7. Cardiology Department, Casilino Polyclinic, Rome, Italy. 8. Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. 9. Radiological Department, European Hospital, Rome, Italy. 10. Cardiac Department, Monzino Cardiology Center, Milano, Italy. 11. Division of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy. 12. Clinical and Experimental Department of Medicine, University of Messina, Messina, Italy.
Abstract
BACKGROUND: The prognostic role of cardiac magnetic resonance (CMR) and late gadolinium enhancement (LGE) has not been clarified in acute myocarditis (AM) with preserved left ventricular (LV) ejection fraction (EF). OBJECTIVES: This study sought to evaluate the role of CMR and LGE in the prognosis of AM with preserved LVEF. METHODS: This study analyzed data from ITAMY (ITalian multicenter study on Acute MYocarditis) and evaluated CMR results from 386 patients (299 male; mean age 35 ± 15 years) with AM and preserved LVEF. Clinical follow-up was performed for a median of 1,572 days. A clinical combined endpoint of cardiac death, appropriate implantable cardioverter-defibrillator firing, resuscitated cardiac arrest, and hospitalization for heart failure was used. RESULTS: Among the 374 patients with suitable images, LGE involved the subepicardial layer inferior and lateral wall in 154 patients (41%; IL group), the midwall layer of the anteroseptal wall in 135 patients (36%; AS [anteroseptal] group), and other segments in 59 patients (16%; other-LGE group), and it was absent in 26 patients (no-LGE group). The AS group had a greater extent of LGE and a higher LV end-diastolic volume index than other groups, but levels of inflammatory markers were lower than in the other groups. Kaplan-Meier curve analysis indicated that the AS group had a worse prognosis than the other groups (p < 0.0001). Finally, in multivariable analysis, AS LGE was the best independent CMR predictor of the combined endpoint (odds ratio: 2.73; 95% confidence interval: 1.2 to 5.9; p = 0.01). CONCLUSIONS: In patients with AM and preserved LVEF, LGE in the midwall layer of the AS myocardial segment is associated with a worse prognosis than other patterns of presentation.
BACKGROUND: The prognostic role of cardiac magnetic resonance (CMR) and late gadolinium enhancement (LGE) has not been clarified in acute myocarditis (AM) with preserved left ventricular (LV) ejection fraction (EF). OBJECTIVES: This study sought to evaluate the role of CMR and LGE in the prognosis of AM with preserved LVEF. METHODS: This study analyzed data from ITAMY (ITalian multicenter study on Acute MYocarditis) and evaluated CMR results from 386 patients (299 male; mean age 35 ± 15 years) with AM and preserved LVEF. Clinical follow-up was performed for a median of 1,572 days. A clinical combined endpoint of cardiac death, appropriate implantable cardioverter-defibrillator firing, resuscitated cardiac arrest, and hospitalization for heart failure was used. RESULTS: Among the 374 patients with suitable images, LGE involved the subepicardial layer inferior and lateral wall in 154 patients (41%; IL group), the midwall layer of the anteroseptal wall in 135 patients (36%; AS [anteroseptal] group), and other segments in 59 patients (16%; other-LGE group), and it was absent in 26 patients (no-LGE group). The AS group had a greater extent of LGE and a higher LV end-diastolic volume index than other groups, but levels of inflammatory markers were lower than in the other groups. Kaplan-Meier curve analysis indicated that the AS group had a worse prognosis than the other groups (p < 0.0001). Finally, in multivariable analysis, AS LGE was the best independent CMR predictor of the combined endpoint (odds ratio: 2.73; 95% confidence interval: 1.2 to 5.9; p = 0.01). CONCLUSIONS: In patients with AM and preserved LVEF, LGE in the midwall layer of the AS myocardial segment is associated with a worse prognosis than other patterns of presentation.
Authors: Lili Zhang; Maeve Jones-O'Connor; Magid Awadalla; Daniel A Zlotoff; Paaladinesh Thavendiranathan; John D Groarke; Alexandra-Chloe Villani; Alexander R Lyon; Tomas G Neilan Journal: Curr Treat Options Cardiovasc Med Date: 2019-06-08
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214
Authors: Joshua A Silverblatt; Oliver J Ziff; Luke Dancy; Allen Daniel; Ben Carter; Paul Scott; Daniel M Sado; Ajay Shah; Daniel I Bromage Journal: Basic Res Cardiol Date: 2019-10-31 Impact factor: 17.165