Cardiovascular magnetic resonance predictors of clinical outcome in patients with suspected acute myocarditis
Open accessAbstract
BACKGROUND: The natural history of acute myocarditis (AM) remains highly variable and predictors of outcome are largely unknown. The objectives were to determine the potential value of various cardiovascular magnetic resonance (CMR) parameters for the prediction of adverse long-term outcome in patients presenting with suspected AM. METHODS: In a single-centre longitudinal prospective study, 203 routine consecutive patients with an initial CMR-based diagnosis of AM (typical Late Gadolinium Enhancement, LGE) were followed over a mean period of 18.9 ± 8.2 months. Various CMR parameters were evaluated as potential predictors of outcome. The primary endpoint was defined as the occurrence of at least one of the combined Major Adverse Clinical Events (MACE) (cardiac death or aborted sudden cardiac death, cardiac transplantation, sustained documented ventricular tachycardia, heart failure, recurrence of acute myocarditis, and the need for hospitalization for cardiac causes). RESULTS: The vast majority of patients (N = 143,70 %) presented with chest pain, mild to moderate troponin elevation and ST-segment or T wave abnormalities. Various CMR parameters were evaluated on initial CMR performed 3 ± 2 days after acute clinical presentation (LV functional parameters, presence/extent of edema on T2 CMR, and extent of late gadolinium enhancement lesions). Out of the 203 patients, 22 experienced at least one major cardiovascular event (10.8 %) during follow-up for a total of 31 major cardiovascular events. Among all CMR parameters, the only independent CMR predictor of adverse clinical outcome by multivariate analysis was an initial alteration of LVEF (p = 0.04). CONCLUSIONS: In routine consecutive patients without severe hemodynamic compromise and a CMR-based diagnosis of AM, various CMR parameters such as the presence and extent of myocardial edema and the extent of late gadolinium-enhanced LV myocardial lesions were not predictive of outcome. The only independent CMR predictor of adverse clinical outcome was an initial alteration of LVEF.
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Chest pain is the most commonly reported symptom in myocarditis, occurring in 82% to 95% of cases.
“the most commonly reported symptom is chest pain (82% to 95% of cases)”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [226]
Table 1 in Results > Study population lists chest pain in 143, 22, and 16 of the 203 patients with suspected acute myocarditis—181 patients, or about 89%, making it the predominant presentation in this cohort. The paper does not report an 82%–95% range or establish that range for myocarditis cases generally. (LLM, conf=0.86)
Experimental — accuracy not yet measuredChest pain in myocarditis can be pleuritic and positional or pressure-like mimicking acute coronary syndrome.
“which can be pleuritic and positional, similar to that of pericarditis, or pressure-like mimicking the pain of acute coronary syndrome.”
From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [226]
The Results (Study population; page unavailable) describe chest pain that varied with respiratory motion and identify an acute coronary syndrome-like presentation. They do not describe the pain as positional or pressure-like, so those specific characteristics are unsupported by this source. (LLM, conf=0.86)
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- Authors
- Sanguineti, F., Garot, P., Mana, M., O'h-Ici, D., Hovasse, T., Unterseeh, T., Louvard, Y., Troussier, X., Morice, M.-C., & Garot, J.
- Affiliations
- Institut Cardiovasculaire Paris Sud (FR)
- Corresponding author
- Garot, Philippe
- Garot, Jérôme
- Venue
- Journal of Cardiovascular Magnetic Resonance
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 17
- Issue
- 1
- Pages
- 78
- ISSN
- 1097-6647 (ISSN-L)
- PMC
- PMC4553007
- OpenAlex
- W1915868854
- Cited by
- 99
- References
- 0
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 13 · 2023: 7 · 2022: 13 · 2021: 6 · 2020: 15 · 2019: 5 · 2018: 7 · 2017: 10 · 2016: 7
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Cardiovascular Magnetic Resonance (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- 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
- acute myocarditis, cardiovascular magnetic resonance, late gadolinium enhancement, myocardial edema, left ventricular ejection fraction, major adverse clinical events, prognosis, long-term outcomes, ventricular tachycardia, heart failure, sudden cardiac death
- MeSH terms
- Acute Disease, Adult, Contrast Media, Edema, Cardiac, Female, France, Humans, Longitudinal Studies, Male, Meglumine, Middle Aged, Myocarditis, Myocardium, Organometallic Compounds, Predictive Value of Tests, Prospective Studies, Risk Factors, Severity of Illness Index, Stroke Volume, Time Factors, Multivariate Analysis, Chi-Square Distribution, Proportional Hazards Models, Ventricular Function, Left, Treatment Outcome, Disease Progression, Magnetic Resonance Imaging, Cine
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