Predictive value of cardiac magnetic resonance right ventricular longitudinal strain in patients with suspected myocarditis

Journal of Cardiovascular Magnetic Resonance

Research

Dominik C. Benz¹  Raymond Y. Kwong¹  Anselm W. Stark²  Maryam Pavlicek-Bahlo²  Kady Fischer²  Dominik P. Guensch²  Yasaman Safarkhanlo²  Jonathan Schütze²  Simon Greulich³  Christoph Gräni⁴  Davide Garachemani⁴  Benedikt Bernhard⁴  Giulin Tanner⁴  Aaron Schnyder⁴  Adrian T. Huber⁵  Jessica A. M. Bastiaansen⁵ 

[1] Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA;Department of Anesthesiology and Pain Medicine, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland;Department of Cardiology and Angiology, University of Tübingen, Tübingen, Germany;Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland;Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;

关键词: Myocarditis;    Right ventricle;    Cardiac magnetic resonance imaging;    Feature tracking;    Right ventricular global longitudinal strain;    Heart failure hospitalizations;   

DOI  :  10.1186/s12968-023-00957-6

 received in 2023-02-23, accepted in 2023-08-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRecent 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.MethodsPatients 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.ResultsAmong 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.ConclusionRV 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.

【 授权许可】

CC BY   
© Society for Cardiovascular Magnetic Resonance 2023

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