Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis
BackgroundCardiac magnetic resonance (CMR) can detect inflammatory myocardial alterations in patients suspected of having acute myocarditis. There is limited information regarding the degree of normalization of CMR parameters during the course of the disease and the time window during which quantita...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.003603 |
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| author | Julian A. Luetkens Rami Homsi Darius Dabir Daniel L. Kuetting Christian Marx Jonas Doerner Ulrike Schlesinger‐Irsch René Andrié Alois M. Sprinkart Frederic C. Schmeel Christian Stehning Rolf Fimmers Juergen Gieseke Claas P. Naehle Hans H. Schild Daniel K. Thomas |
| author_facet | Julian A. Luetkens Rami Homsi Darius Dabir Daniel L. Kuetting Christian Marx Jonas Doerner Ulrike Schlesinger‐Irsch René Andrié Alois M. Sprinkart Frederic C. Schmeel Christian Stehning Rolf Fimmers Juergen Gieseke Claas P. Naehle Hans H. Schild Daniel K. Thomas |
| author_sort | Julian A. Luetkens |
| collection | DOAJ |
| description | BackgroundCardiac magnetic resonance (CMR) can detect inflammatory myocardial alterations in patients suspected of having acute myocarditis. There is limited information regarding the degree of normalization of CMR parameters during the course of the disease and the time window during which quantitative CMR should be most reasonably implemented for diagnostic work‐up. Methods and ResultsTwenty‐four patients with suspected acute myocarditis and 45 control subjects underwent CMR. Initial CMR was performed 2.6±1.9 days after admission. Myocarditis patients underwent CMR follow‐up after 2.4±0.6, 5.5±1.3, and 16.2±9.9 weeks. The CMR protocol included assessment of standard Lake Louise criteria, T1 relaxation times, extracellular volume fraction, and T2 relaxation times. Group differences between myocarditis patients and control subjects were highest in the acute stage of the disease (P<0.001 for all parameters). There was a significant and consistent decrease in all inflammatory CMR parameters over the course of the disease (P<0.01 for all parameters). Myocardial T1 and T2 relaxation times—indicative of myocardial edema—were the only single parameters showing significant differences between myocarditis patients and control subjects on 5.5±1.3‐week follow‐up (T1: 986.5±44.4 ms versus 965.1±28.1 ms, P=0.022; T2: 55.5±3.2 ms versus 52.6±2.6 ms; P=0.001). ConclusionsIn patients with acute myocarditis, CMR markers of myocardial inflammation demonstrated a rapid and continuous decrease over several follow‐up examinations. CMR diagnosis of myocarditis should therefore be attempted at an early stage of the disease. Myocardial T1 and T2 relaxation times were the only parameters of active inflammation/edema that could discriminate between myocarditis patients and control subjects even at a convalescent stage of the disease. |
| first_indexed | 2024-12-13T09:04:21Z |
| format | Article |
| id | doaj.art-962fe22464ec44f6a71529b33632f0d7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:04:21Z |
| publishDate | 2016-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-962fe22464ec44f6a71529b33632f0d72022-12-21T23:53:05ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-07-015710.1161/JAHA.116.003603Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute MyocarditisJulian A. Luetkens0Rami Homsi1Darius Dabir2Daniel L. Kuetting3Christian Marx4Jonas Doerner5Ulrike Schlesinger‐Irsch6René Andrié7Alois M. Sprinkart8Frederic C. Schmeel9Christian Stehning10Rolf Fimmers11Juergen Gieseke12Claas P. Naehle13Hans H. Schild14Daniel K. Thomas15Department of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Cardiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyPhilips Research, Hamburg, GermanyDepartment of Medical Biometry, Informatics, and Epidemiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyDepartment of Radiology, University of Bonn, GermanyBackgroundCardiac magnetic resonance (CMR) can detect inflammatory myocardial alterations in patients suspected of having acute myocarditis. There is limited information regarding the degree of normalization of CMR parameters during the course of the disease and the time window during which quantitative CMR should be most reasonably implemented for diagnostic work‐up. Methods and ResultsTwenty‐four patients with suspected acute myocarditis and 45 control subjects underwent CMR. Initial CMR was performed 2.6±1.9 days after admission. Myocarditis patients underwent CMR follow‐up after 2.4±0.6, 5.5±1.3, and 16.2±9.9 weeks. The CMR protocol included assessment of standard Lake Louise criteria, T1 relaxation times, extracellular volume fraction, and T2 relaxation times. Group differences between myocarditis patients and control subjects were highest in the acute stage of the disease (P<0.001 for all parameters). There was a significant and consistent decrease in all inflammatory CMR parameters over the course of the disease (P<0.01 for all parameters). Myocardial T1 and T2 relaxation times—indicative of myocardial edema—were the only single parameters showing significant differences between myocarditis patients and control subjects on 5.5±1.3‐week follow‐up (T1: 986.5±44.4 ms versus 965.1±28.1 ms, P=0.022; T2: 55.5±3.2 ms versus 52.6±2.6 ms; P=0.001). ConclusionsIn patients with acute myocarditis, CMR markers of myocardial inflammation demonstrated a rapid and continuous decrease over several follow‐up examinations. CMR diagnosis of myocarditis should therefore be attempted at an early stage of the disease. Myocardial T1 and T2 relaxation times were the only parameters of active inflammation/edema that could discriminate between myocarditis patients and control subjects even at a convalescent stage of the disease.https://www.ahajournals.org/doi/10.1161/JAHA.116.003603diagnosisfollow‐up studymagnetic resonance imagingmappingmyocarditis |
| spellingShingle | Julian A. Luetkens Rami Homsi Darius Dabir Daniel L. Kuetting Christian Marx Jonas Doerner Ulrike Schlesinger‐Irsch René Andrié Alois M. Sprinkart Frederic C. Schmeel Christian Stehning Rolf Fimmers Juergen Gieseke Claas P. Naehle Hans H. Schild Daniel K. Thomas Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease diagnosis follow‐up study magnetic resonance imaging mapping myocarditis |
| title | Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis |
| title_full | Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis |
| title_fullStr | Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis |
| title_full_unstemmed | Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis |
| title_short | Comprehensive Cardiac Magnetic Resonance for Short‐Term Follow‐Up in Acute Myocarditis |
| title_sort | comprehensive cardiac magnetic resonance for short term follow up in acute myocarditis |
| topic | diagnosis follow‐up study magnetic resonance imaging mapping myocarditis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.003603 |
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