Correlation between clinical presentation and delayed-enhancement MRI pattern in myocarditis

Purpose The exact incidence of myocarditis is unknown, as the diagnosis is frequently delayed or missed. Clinical presentation and disease course are extremely variable, as there may be acute onset with acute coronary syndrome, or cardiogenic shock, or progressive heart failure or arrhythmias. The p...

Full description

Saved in:
Bibliographic Details
Published in:Radiologia medica 2012-12, Vol.117 (8), p.1309-1319
Main Authors: Natale, L., De Vita, A., Baldari, C., Meduri, A., Pieroni, M., Lombardo, A., Crea, F., Bonomo, L.
Format: Article
Language:eng ; ita
Subjects:
Adolescent
Adult
Aged
Cardiac Radiology
Cardioradiologia
Contrast Media
Diagnostic Radiology
Echocardiography, Doppler
Female
Humans
Imaging
Interventional Radiology
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Myocarditis - diagnosis
Myocarditis - diagnostic imaging
Myocarditis - physiopathology
Neuroradiology
Prognosis
Radiology
Ultrasound
Ventricular Function, Left
Ventricular Remodeling
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose The exact incidence of myocarditis is unknown, as the diagnosis is frequently delayed or missed. Clinical presentation and disease course are extremely variable, as there may be acute onset with acute coronary syndrome, or cardiogenic shock, or progressive heart failure or arrhythmias. The purpose of this study was to identify prognostic factors on magnetic resonance imaging (MRI) performed in patients with bioptically proven myocarditis at presentation and after 6 months. Materials and methods Fifty-six consecutive patients with different presentations of myocarditis (20 with acute coronary syndrome, 20 with heart failure, 16 with arrhythmias) were enrolled. All patients underwent B-mode echocardiography (echo) and tissue Doppler imaging, coronarography, ventriculography, endomyocardial biopsy and contrast-enhanced MRI examination, as well as clinical and echo follow-up at 6 months. Results At 6-month follow-up, patients were divided in two groups according to values of end-systolic volume and ejection fraction: patients with negative remodelling and those with positive remodelling. Late enhancement was found to be an independent predictor of negative remodelling. Conclusions Contrast-enhanced MRI is useful both in the diagnosis and as a prognostic indicator in the clinical suspicion of myocarditis.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-012-0790-x