Cargando…

2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?

Background: The aim of present study was to assess left ventricular myocardial deformation detected by 2D STE in patients with suspected acute myocarditis (AM) early on admission in whom later cardiac magnetic resonance (CMR) evaluation was performed. Methods: A total of 47 patients with suspected A...

Descripción completa

Detalles Bibliográficos
Autores principales: Supeł, Karolina, Wieczorkiewicz, Paulina, Przybylak, Katarzyna, Zielińska, Marzenna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146770/
https://www.ncbi.nlm.nih.gov/pubmed/37109114
http://dx.doi.org/10.3390/jcm12082777
_version_ 1785034657990967296
author Supeł, Karolina
Wieczorkiewicz, Paulina
Przybylak, Katarzyna
Zielińska, Marzenna
author_facet Supeł, Karolina
Wieczorkiewicz, Paulina
Przybylak, Katarzyna
Zielińska, Marzenna
author_sort Supeł, Karolina
collection PubMed
description Background: The aim of present study was to assess left ventricular myocardial deformation detected by 2D STE in patients with suspected acute myocarditis (AM) early on admission in whom later cardiac magnetic resonance (CMR) evaluation was performed. Methods: A total of 47 patients with suspected AM based on clinical practice were prospectively enrolled. Coronary angiography was performed on all patients to rule out significant coronary artery disease. CMR confirmed myocardial inflammation, oedema, and regional necrosis meeting the Lake Louise criteria in 25 patients (53%, oedema (+) subgroup). In the remaining patients, only LGE was confirmed in the sub-epicardial or intramuscular localization (22 patients, 47%, oedema (−) subgroup). Early on admission, echocardiography with measurements of global and segmental longitudinal strains (GLS), circumferential strains (GCS) at the endocardial (endocardial GCS) and epicardial (epicardial GCS) layers, transmural GCS, and radial strains (RS) were performed. Results: Mild reduction of GLS, GRS, and transmural GCS values were found in patients with oedema (+) subgroup. The epicardial GCS turned out to be the diagnostic factor for oedema with a cut-off point of 13,0% (AUC 0.747, p = 0.0005). Twenty-two patients (all but three) with an acute phase of myocarditis and epicardial GCS −13.0% or less had oedema confirmed by CMR. Conclusions: 2D STE can help to set the diagnosis of AM in patients with acute chest pain with a normal coronary angiogram. The epicardial GCS can serve as a diagnostic factor for oedema in patients with early stage of AM. In patients presenting with signs of AM (oedema in CMR), the epicardial GCS is modified in comparison with a subgroup without oedema; therefore, this parameter could be used to improve the performance of ultrasound.
format Online
Article
Text
id pubmed-10146770
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101467702023-04-29 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease? Supeł, Karolina Wieczorkiewicz, Paulina Przybylak, Katarzyna Zielińska, Marzenna J Clin Med Article Background: The aim of present study was to assess left ventricular myocardial deformation detected by 2D STE in patients with suspected acute myocarditis (AM) early on admission in whom later cardiac magnetic resonance (CMR) evaluation was performed. Methods: A total of 47 patients with suspected AM based on clinical practice were prospectively enrolled. Coronary angiography was performed on all patients to rule out significant coronary artery disease. CMR confirmed myocardial inflammation, oedema, and regional necrosis meeting the Lake Louise criteria in 25 patients (53%, oedema (+) subgroup). In the remaining patients, only LGE was confirmed in the sub-epicardial or intramuscular localization (22 patients, 47%, oedema (−) subgroup). Early on admission, echocardiography with measurements of global and segmental longitudinal strains (GLS), circumferential strains (GCS) at the endocardial (endocardial GCS) and epicardial (epicardial GCS) layers, transmural GCS, and radial strains (RS) were performed. Results: Mild reduction of GLS, GRS, and transmural GCS values were found in patients with oedema (+) subgroup. The epicardial GCS turned out to be the diagnostic factor for oedema with a cut-off point of 13,0% (AUC 0.747, p = 0.0005). Twenty-two patients (all but three) with an acute phase of myocarditis and epicardial GCS −13.0% or less had oedema confirmed by CMR. Conclusions: 2D STE can help to set the diagnosis of AM in patients with acute chest pain with a normal coronary angiogram. The epicardial GCS can serve as a diagnostic factor for oedema in patients with early stage of AM. In patients presenting with signs of AM (oedema in CMR), the epicardial GCS is modified in comparison with a subgroup without oedema; therefore, this parameter could be used to improve the performance of ultrasound. MDPI 2023-04-08 /pmc/articles/PMC10146770/ /pubmed/37109114 http://dx.doi.org/10.3390/jcm12082777 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Supeł, Karolina
Wieczorkiewicz, Paulina
Przybylak, Katarzyna
Zielińska, Marzenna
2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title_full 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title_fullStr 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title_full_unstemmed 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title_short 2D Strain Analysis in Myocarditis—Can We Be Any Closer to Diagnose the Acute Phase of the Disease?
title_sort 2d strain analysis in myocarditis—can we be any closer to diagnose the acute phase of the disease?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146770/
https://www.ncbi.nlm.nih.gov/pubmed/37109114
http://dx.doi.org/10.3390/jcm12082777
work_keys_str_mv AT supełkarolina 2dstrainanalysisinmyocarditiscanwebeanyclosertodiagnosetheacutephaseofthedisease
AT wieczorkiewiczpaulina 2dstrainanalysisinmyocarditiscanwebeanyclosertodiagnosetheacutephaseofthedisease
AT przybylakkatarzyna 2dstrainanalysisinmyocarditiscanwebeanyclosertodiagnosetheacutephaseofthedisease
AT zielinskamarzenna 2dstrainanalysisinmyocarditiscanwebeanyclosertodiagnosetheacutephaseofthedisease