Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis
Abstract Background Recent evidence underlined the importance of right (RV) involvement in suspected myocarditis. We aim to analyze the possible incremental prognostic value from RV global longitudinal strain (GLS) by CMR. Methods Patients referred for CMR, meeting clinical criteria for suspected my...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-023-00957-6 |
| _version_ | 1827267239008534528 |
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| author | Benedikt Bernhard Giulin Tanner Davide Garachemani Aaron Schnyder Kady Fischer Adrian T. Huber Yasaman Safarkhanlo Anselm W. Stark Dominik P. Guensch Jonathan Schütze Simon Greulich Jessica A. M. Bastiaansen Maryam Pavlicek-Bahlo Dominik C. Benz Raymond Y. Kwong Christoph Gräni |
| author_facet | Benedikt Bernhard Giulin Tanner Davide Garachemani Aaron Schnyder Kady Fischer Adrian T. Huber Yasaman Safarkhanlo Anselm W. Stark Dominik P. Guensch Jonathan Schütze Simon Greulich Jessica A. M. Bastiaansen Maryam Pavlicek-Bahlo Dominik C. Benz Raymond Y. Kwong Christoph Gräni |
| author_sort | Benedikt Bernhard |
| collection | DOAJ |
| description | Abstract Background Recent evidence underlined the importance of right (RV) involvement in suspected myocarditis. We aim to analyze the possible incremental prognostic value from RV global longitudinal strain (GLS) by CMR. Methods Patients referred for CMR, meeting clinical criteria for suspected myocarditis and no other cardiomyopathy were enrolled in a dual-center register cohort study. Ejection fraction (EF), GLS and tissue characteristics were assessed in both ventricles to assess their association to first major adverse cardiovascular events (MACE) including hospitalization for heart failure (HF), ventricular tachycardia (VT), recurrent myocarditis and death. Results Among 659 patients (62.8% male; 48.1 ± 16.1 years), RV GLS was impaired (> − 15.4%) in 144 (21.9%) individuals, of whom 76 (58%), 108 (77.1%), 27 (18.8%) and 40 (32.8%) had impaired right ventricular ejection fraction (RVEF), impaired left ventricular ejection fraction (LVEF), RV late gadolinium enhancement (LGE) or RV edema, respectively. After a median observation time of 3.7 years, 45 (6.8%) patients were hospitalized for HF, 42 (6.4%) patients died, 33 (5%) developed VT and 16 (2.4%) had recurrent myocarditis. Impaired RV GLS was associated with MACE (HR = 1.07, 95% CI 1.04–1.10; p < 0.001), HF hospitalization (HR = 1.17, 95% CI 1.12–1.23; p < 0.001), and death (HR = 1.07, 95% CI 1.02–1.12; p = 0.004), but not with VT and recurrent myocarditis in univariate analysis. RV GLS lost its association with outcomes, when adjusted for RVEF, LVEF, LV GLS and LV LGE extent. Conclusion RV strain is associated with MACE, HF hospitalization and death but has neither independent nor incremental prognostic value after adjustment for RV and LV function and tissue characteristics. Therefore, assessing RV GLS in the setting of myocarditis has only limited value. |
| first_indexed | 2024-03-12T14:16:54Z |
| format | Article |
| id | doaj.art-c92ce091b4ea4ea487d87d3c55c88643 |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2025-03-22T04:30:35Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-c92ce091b4ea4ea487d87d3c55c886432024-04-28T03:59:30ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2023-08-0125111410.1186/s12968-023-00957-6Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditisBenedikt Bernhard0Giulin Tanner1Davide Garachemani2Aaron Schnyder3Kady Fischer4Adrian T. Huber5Yasaman Safarkhanlo6Anselm W. Stark7Dominik P. Guensch8Jonathan Schütze9Simon Greulich10Jessica A. M. Bastiaansen11Maryam Pavlicek-Bahlo12Dominik C. Benz13Raymond Y. Kwong14Christoph Gräni15Department of Cardiology, Inselspital, Bern University Hospital, University of BernDepartment of Cardiology, Inselspital, Bern University Hospital, University of BernDepartment of Cardiology, Inselspital, Bern University Hospital, University of BernDepartment of Cardiology, Inselspital, Bern University Hospital, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernDepartment of Cardiology and Angiology, University of TübingenDepartment of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of BernDepartment of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of BernCardiovascular Division, Department of Medicine, Brigham and Women’s HospitalCardiovascular Division, Department of Medicine, Brigham and Women’s HospitalDepartment of Cardiology, Inselspital, Bern University Hospital, University of BernAbstract Background Recent evidence underlined the importance of right (RV) involvement in suspected myocarditis. We aim to analyze the possible incremental prognostic value from RV global longitudinal strain (GLS) by CMR. Methods Patients referred for CMR, meeting clinical criteria for suspected myocarditis and no other cardiomyopathy were enrolled in a dual-center register cohort study. Ejection fraction (EF), GLS and tissue characteristics were assessed in both ventricles to assess their association to first major adverse cardiovascular events (MACE) including hospitalization for heart failure (HF), ventricular tachycardia (VT), recurrent myocarditis and death. Results Among 659 patients (62.8% male; 48.1 ± 16.1 years), RV GLS was impaired (> − 15.4%) in 144 (21.9%) individuals, of whom 76 (58%), 108 (77.1%), 27 (18.8%) and 40 (32.8%) had impaired right ventricular ejection fraction (RVEF), impaired left ventricular ejection fraction (LVEF), RV late gadolinium enhancement (LGE) or RV edema, respectively. After a median observation time of 3.7 years, 45 (6.8%) patients were hospitalized for HF, 42 (6.4%) patients died, 33 (5%) developed VT and 16 (2.4%) had recurrent myocarditis. Impaired RV GLS was associated with MACE (HR = 1.07, 95% CI 1.04–1.10; p < 0.001), HF hospitalization (HR = 1.17, 95% CI 1.12–1.23; p < 0.001), and death (HR = 1.07, 95% CI 1.02–1.12; p = 0.004), but not with VT and recurrent myocarditis in univariate analysis. RV GLS lost its association with outcomes, when adjusted for RVEF, LVEF, LV GLS and LV LGE extent. Conclusion RV strain is associated with MACE, HF hospitalization and death but has neither independent nor incremental prognostic value after adjustment for RV and LV function and tissue characteristics. Therefore, assessing RV GLS in the setting of myocarditis has only limited value.https://doi.org/10.1186/s12968-023-00957-6MyocarditisRight ventricleCardiac magnetic resonance imagingFeature trackingRight ventricular global longitudinal strainHeart failure hospitalizations |
| spellingShingle | Benedikt Bernhard Giulin Tanner Davide Garachemani Aaron Schnyder Kady Fischer Adrian T. Huber Yasaman Safarkhanlo Anselm W. Stark Dominik P. Guensch Jonathan Schütze Simon Greulich Jessica A. M. Bastiaansen Maryam Pavlicek-Bahlo Dominik C. Benz Raymond Y. Kwong Christoph Gräni Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis Journal of Cardiovascular Magnetic Resonance Myocarditis Right ventricle Cardiac magnetic resonance imaging Feature tracking Right ventricular global longitudinal strain Heart failure hospitalizations |
| title | Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| title_full | Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| title_fullStr | Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| title_full_unstemmed | Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| title_short | Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| title_sort | predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis |
| topic | Myocarditis Right ventricle Cardiac magnetic resonance imaging Feature tracking Right ventricular global longitudinal strain Heart failure hospitalizations |
| url | https://doi.org/10.1186/s12968-023-00957-6 |
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