Details

Autor(en) / Beteiligte

• Barone-Rochette, Gilles
• Augier, Caroline
• Rodière, Mathieu
• Baguet, Jean Philippe
• Fagret, Daniel
• Vanzetto, Gérald

Titel

122: Prognosis of acute myocarditis from late gadolinium enhancement cardiovascular magnetic resonance using a quick and easy score

Ist Teil von

• Archives of Cardiovascular Diseases Supplements, 2013-01, Vol.5 (1), p.40-40

Ort / Verlag

Elsevier France

Erscheinungsjahr

2013

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Cardiac MRI plays an increasingly important role in the diagnosis of acute myocarditis. However, its prognostic value is less well established and requires specific post-processing of images. In a prospective pilot MRI study, we assessed the prognostic value of the evolution in a simplified visual quantitative score (SQS) of late gadolinium enhancement (LGE). Patients hospitalized between June 2008 and January 2011 with a diagnosis of acute myocarditis underwent MRI at initial hospitalization and again at 3-months. The prognostic value of the change in SQS was assessed at one year using a combination of death, heart transplant, and confirmed recurrence as main outcome. Twenty-eight patients were included in this study of which 19 were men (68%). The mean patient age was 33 + 11 years [16 – 57 years]. Patients with stable or an increase in SQS (Δ SQS = 3.53% + 5.31%) suffered more main clinical outcome events than patients with a decrease in SQS (Δ SQS = – 3.47% + 5.50%), with a statistically significant difference (p=0.02). However, at initial admission, we found no significant difference between patients with stable or an increase in SQS and those with decreased SQS regarding other frequently used prognostic variables such as minimum ejection fraction during hospitalization (50±4 vs. 45±9%, p=NS) or peak CPK (877±296 vs. 413±140U/L p=NS). A post-hoc exploratory ROC analysis showed SQS ≥ 7.35 at initial MRI could identify patients with poor prognosis (Se=100%, Sp= 60%, p=0.03). Monitoring of the evolution of delayed contrast enhancement in MRI using a simple quantitative score is of interest for the prognosis of acute myocarditis, to identify patients at risk of death, transplant or recurrence, and to guide patient management.