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Cardiac MR With Late Gadolinium Enhancement in Acute Myocarditis With Preserved Systolic Function: ITAMY Study.
- Source :
-
Journal of the American College of Cardiology (JACC) . Oct2017, Vol. 70 Issue 16, p1977-1987. 11p. - Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>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).<bold>Objectives: </bold>This study sought to evaluate the role of CMR and LGE in the prognosis of AM with preserved LVEF.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CARDIAC magnetic resonance imaging
*MYOCARDITIS
*CARDIAC contraction
*VENTRICULAR ejection fraction
*CARDIAC arrest
*LEFT heart ventricle
*HEART physiology
*CHEMICAL elements
*COMPARATIVE studies
*LONGITUDINAL method
*MAGNETIC resonance imaging
*RESEARCH methodology
*MEDICAL cooperation
*CARDIOMYOPATHIES
*RADIOISOTOPES
*RESEARCH
*EVALUATION research
*ACUTE diseases
*CORONARY angiography
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Volume :
- 70
- Issue :
- 16
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Cardiology (JACC)
- Publication Type :
- Academic Journal
- Accession number :
- 125415695
- Full Text :
- https://doi.org/10.1016/j.jacc.2017.08.044