Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis
-
Published:2023-08-17
Issue:1
Volume:25
Page:
-
ISSN:1532-429X
-
Container-title:Journal of Cardiovascular Magnetic Resonance
-
language:en
-
Short-container-title:J Cardiovasc Magn Reson
Author:
Bernhard Benedikt,Tanner Giulin,Garachemani Davide,Schnyder Aaron,Fischer Kady,Huber Adrian T.,Safarkhanlo Yasaman,Stark Anselm W.,Guensch Dominik P.,Schütze Jonathan,Greulich Simon,Bastiaansen Jessica A. M.,Pavlicek-Bahlo Maryam,Benz Dominik C.,Kwong Raymond Y.,Gräni Christoph
Abstract
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.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology
Reference43 articles.
1. Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013;34(2636–48):2648a–2648d. https://doi.org/10.1093/eurheartj/eht210. 2. Cooper LT Jr. Myocarditis. N Engl J Med. 2009;360:1526–38. https://doi.org/10.1056/NEJMra0800028. 3. Eichhorn C, Bière L, Schnell F, Schmied C, Wilhelm M, Kwong RY, Gräni C. Myocarditis in athletes is a challenge: diagnosis, risk stratification, and uncertainties. JACC Cardiovasc Imaging. 2020;13:494–507. https://doi.org/10.1016/j.jcmg.2019.01.039. 4. Aquaro GD, Negri F, De Luca A, Todiere G, Bianco F, Barison A, Camastra G, Monti L, Dellegrottaglie S, Moro C, Lanzillo C, Scatteia A, Di Roma M, Pontone G, Perazzolo Marra M, Di Bella G, Donato R, Grigoratos C, Emdin M, Sinagra G. Role of right ventricular involvement in acute myocarditis, assessed by cardiac magnetic resonance. Int J Cardiol. 2018;271:359–65. https://doi.org/10.1016/j.ijcard.2018.04.087. 5. Bernhard B, Schnyder A, Garachemani D, Fischer K, Tanner G, Safarkhanlo Y, Stark AW, Schütze J, Pavlicek-Bahlo M, Greulich S, Johner C, Wahl A, Benz DC, Kwong RY, Gräni C. Prognostic value of right ventricular function in patients with suspected myocarditis undergoing cardiac magnetic resonance. JACC Cardiovasc Imaging. 2023;16:28–41. https://doi.org/10.1016/j.jcmg.2022.08.011.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|