The Diagnostic and Prognostic Utility of Contemporary Cardiac Magnetic Resonance in Suspected Acute Myocarditis

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Jakub Lagan
  • Christien Fortune
  • Richard Timoney
  • Daniel Prescott
  • Hamish D. C. Bain
  • Tasneem Bangi
  • Jerome Mcintosh
  • Robin Egdell
  • R. Bruce Irwin
  • David Clark
  • Erik B. Schelbert
  • Gaetano Nucifora
  • Matthias Schmitt

Abstract

Cardiovascular magnetic resonance (CMR) is used to investigate suspected acute myocarditis, however most supporting data is retrospective and few studies have included parametric mapping. We aimed to investigate the utility of contemporary multiparametric CMR in a large prospective cohort of patients with suspected acute myocarditis, the impact of real-world variations in practice, the relationship between clinical characteristics and CMR findings and factors predicting outcome. 540 consecutive patients we recruited. The 113 patients diagnosed with myocarditis on CMR performed within 40 days of presentation were followed-up for 674 (504-915) days. 39 patients underwent follow-up CMR at 189 (166-209) days. CMR provided a positive diagnosis in 72% of patients, including myocarditis (40%) and myocardial infarction (11%). In multivariable analysis, male sex and shorter presentation-to-scan interval were associated with a diagnosis of myocarditis. Presentation with heart failure (HF) was associated with lower left ventricular ejection fraction (LVEF), higher LGE burden and higher extracellular volume fraction. Lower baseline LVEF predicted follow-up LV dysfunction. Multiparametric CMR has a high diagnostic yield in suspected acute myocarditis. CMR should be performed early and include parametric mapping. Patients presenting with HF and reduced LVEF require closer follow-up while those with normal CMR may not require it.

Keywords: Myocarditis; Magnetic resonance imaging; Parametric mapping

Bibliographical metadata

Original languageEnglish
Pages (from-to)156
JournalDiagnostics
Volume12
Issue number1
Early online date10 Jan 2022
DOIs
Publication statusPublished - 10 Jan 2022