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Cited by 2,059Viral Infections and Immunology ResearchCardiac Imaging and DiagnosticsCardiomyopathy and Myosin Studies

Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation

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Ferreira, Vanessa M., Schulz-Menger, Jeanette, Holmvang, Godtfred, Kramer, Christopher M., Carbone, Iacopo, Sechtem, Udo, Kindermann, Ingrid, Gutberlet, Matthias +3 more·2018·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2018.09.072
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Abstract

This JACC Scientific Expert Panel provides consensus recommendations for an update of the cardiovascular magnetic resonance (CMR) diagnostic criteria for myocardial inflammation in patients with suspected acute or active myocardial inflammation (Lake Louise Criteria) that include options to use parametric mapping techniques. While each parameter may indicate myocardial inflammation, the authors propose that CMR provides strong evidence for myocardial inflammation, with increasing specificity, if the CMR scan demonstrates the combination of myocardial edema with other CMR markers of inflammatory myocardial injury. This is based on at least one T2-based criterion (global or regional increase of myocardial T2 relaxation time or an increased signal intensity in T2-weighted CMR images), with at least one T1-based criterion (increased myocardial T1, extracellular volume, or late gadolinium enhancement). While having both a positive T2-based marker and a T1-based marker will increase specificity for diagnosing acute myocardial inflammation, having only one (i.e., T2-based OR T1-based) marker may still support a diagnosis of acute myocardial inflammation in an appropriate clinical scenario, albeit with less specificity. The update is expected to improve the diagnostic accuracy of CMR further in detecting myocardial inflammation.

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  • Pre-COVID myocarditis occurs more often in young men under 50 years, with a sex ratio of 2 to 4:1 men to women.

    “Myocarditis pre-COVID is known to occur more often in young men under the age of 50 years, with a sex ratio of 2 to 4:1 men to women”

    From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [117]

    The “Infarct-like acute myocarditis” section (page not provided) says a severe presentation of acute viral myocarditis occurs mostly in younger patients, especially men. It does not establish that myocarditis generally occurs more often in men under 50 or give a male-to-female ratio of 2–4:1. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The updated 2018 Lake Louise criteria for myocarditis are based on the presence and pattern of myocardial edema on T2 sequencing and inflammatory myocardial injury on T1 sequencing.

    “The updated 2018 Lake Louise criteria for myocarditis are based on the presence and pattern of myocardial edema (detected on T2 sequencing) and inflammatory myocardial injury (detected on T1 sequencing)”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [239]

  • Women are more likely to develop myocarditis after menopause.

    “while women are more likely to develop myocarditis after menopause, which is reviewed in previous studies. 64,113-117”

    From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [117]

    The Autoimmune Myocarditis section mentions a study of female patients with rheumatoid arthritis, and the discussion of peripartum cardiomyopathy mentions possible myocardial inflammation. Neither addresses whether women are more likely to develop myocarditis after menopause. Searches for menopause, postmenopausal risk, and sex differences found no passage supporting that comparison; page numbers were unavailable in our copy. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • The updated 2018 Lake Louise criteria have a sensitivity of 87.5% and specificity of 96.2% for acute myocarditis.

    “with a sensitivity of 87 .5% and specificity of 96.2% for acute myocarditis.”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [239]

    The “Update to the Lake Louise Criteria” section describes the revised diagnostic criteria but gives no sensitivity or specificity for them. Searches for 87.5% and 96.2% found neither figure; the Abstract’s different figures concern the original criteria, so they do not establish the claimed performance of the 2018 update. Page numbers were unavailable in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Authors
Ferreira, V. M., Schulz-Menger, J., Holmvang, G., Kramer, C. M., Carbone, I., Sechtem, U., Kindermann, I., Gutberlet, M., Cooper, L. T., Liu, P., & Friedrich, M. G.
Affiliations
  • John Radcliffe Hospital (GB)
  • Massachusetts General Hospital (US)
  • University of Virginia Health System (US)
  • Sapienza University of Rome (IT)
  • Robert Bosch Hospital (DE)
  • Universitätsklinikum des Saarlandes (DE)
  • Leipzig University (DE)
  • Mayo Clinic (US)
  • Ottawa Heart Institute (CA)
  • McGill University Health Centre (CA)
Corresponding author
Friedrich, Matthias G.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2018-12
Volume
72
Issue
24
Pages
3158-3176
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2018.09.072
OpenAlex
W2903759577
Cited by
2,059
References
0
Citations by year
2026: 295 · 2025: 231 · 2024: 285 · 2023: 339 · 2022: 377 · 2021: 287 · 2020: 179 · 2019: 61 · 2014: 1
FWCI
24.62
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, other-oa)
Funders
  • American College of Cardiology Foundation
  • McGill University Health Centre
  • University of Oxford
  • Universität Heidelberg
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
Keywords
cardiovascular magnetic resonance, myocarditis, Lake Louise criteria, myocardial edema, T2 relaxation time, T1 mapping, extracellular volume, late gadolinium enhancement, parametric mapping, diagnostic criteria
MeSH terms
Humans, Magnetic Resonance Imaging, Myocarditis, Patient Selection, Cardiac Imaging Techniques

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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