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Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study

BACKGROUND: Myocardial edema is a substantial feature of the inflammatory response in human myocarditis. The relation between myocardial edema and myocardial mass in the course of healing myocarditis has not been systematically investigated. We hypothesised that the resolution of myocardial edema as...

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Autores principales: Zagrosek, Anja, Wassmuth, Ralf, Abdel-Aty, Hassan, Rudolph, André, Dietz, Rainer, Schulz-Menger, Jeanette
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396625/
https://www.ncbi.nlm.nih.gov/pubmed/18447954
http://dx.doi.org/10.1186/1532-429X-10-19
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author Zagrosek, Anja
Wassmuth, Ralf
Abdel-Aty, Hassan
Rudolph, André
Dietz, Rainer
Schulz-Menger, Jeanette
author_facet Zagrosek, Anja
Wassmuth, Ralf
Abdel-Aty, Hassan
Rudolph, André
Dietz, Rainer
Schulz-Menger, Jeanette
author_sort Zagrosek, Anja
collection PubMed
description BACKGROUND: Myocardial edema is a substantial feature of the inflammatory response in human myocarditis. The relation between myocardial edema and myocardial mass in the course of healing myocarditis has not been systematically investigated. We hypothesised that the resolution of myocardial edema as visualised by T2-weighted cardiovascular magnetic resonance (CMR) is associated with a decrease of myocardial mass in steady state free precession (SSFP)-cine imaging. METHODS: 21 patients with acute myocarditis underwent CMR shortly after onset of symptoms and 1 year later. For visualization of edema, a T2-weighted breath-hold black-blood triple-inversion fast spin echo technique was applied and the ratio of signal intensity of myocardium/skeletal muscle was assessed. Left ventricular (LV) mass, volumes and function were quantified from biplane cine steady state free precession images. 11 healthy volunteers served as a control group for interstudy reproducibility of LV mass. RESULTS: In patients with myocarditis, a significant decrease in LV mass was observed during follow-up compared to the acute phase (156.7 ± 30.6 g vs. 140.3 ± 28.3 g, p < 0.0001). The reduction of LV mass paralleled the normalization of initially increased myocardial signal intensity on T2-weighted images (2.4 ± 0.4 vs. 1.68 ± 0.3, p < 0.0001). In controls, the interstudy difference of LV mass was lower than in patients (5.1 ± 2.9 g vs. 16.3 ± 14.2 g, p = 0.02) resulting in a lower coefficient of variability (2.1 vs 8.9%, p = 0.04). CONCLUSION: Reversible abnormalities in T2-weighted CMR are paralleled by a transient increase in left ventricular mass during the course of myocarditis. Myocardial edema may be a common pathway explaining these findings.
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spelling pubmed-23966252008-05-28 Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study Zagrosek, Anja Wassmuth, Ralf Abdel-Aty, Hassan Rudolph, André Dietz, Rainer Schulz-Menger, Jeanette J Cardiovasc Magn Reson Research BACKGROUND: Myocardial edema is a substantial feature of the inflammatory response in human myocarditis. The relation between myocardial edema and myocardial mass in the course of healing myocarditis has not been systematically investigated. We hypothesised that the resolution of myocardial edema as visualised by T2-weighted cardiovascular magnetic resonance (CMR) is associated with a decrease of myocardial mass in steady state free precession (SSFP)-cine imaging. METHODS: 21 patients with acute myocarditis underwent CMR shortly after onset of symptoms and 1 year later. For visualization of edema, a T2-weighted breath-hold black-blood triple-inversion fast spin echo technique was applied and the ratio of signal intensity of myocardium/skeletal muscle was assessed. Left ventricular (LV) mass, volumes and function were quantified from biplane cine steady state free precession images. 11 healthy volunteers served as a control group for interstudy reproducibility of LV mass. RESULTS: In patients with myocarditis, a significant decrease in LV mass was observed during follow-up compared to the acute phase (156.7 ± 30.6 g vs. 140.3 ± 28.3 g, p < 0.0001). The reduction of LV mass paralleled the normalization of initially increased myocardial signal intensity on T2-weighted images (2.4 ± 0.4 vs. 1.68 ± 0.3, p < 0.0001). In controls, the interstudy difference of LV mass was lower than in patients (5.1 ± 2.9 g vs. 16.3 ± 14.2 g, p = 0.02) resulting in a lower coefficient of variability (2.1 vs 8.9%, p = 0.04). CONCLUSION: Reversible abnormalities in T2-weighted CMR are paralleled by a transient increase in left ventricular mass during the course of myocarditis. Myocardial edema may be a common pathway explaining these findings. BioMed Central 2008-04-30 /pmc/articles/PMC2396625/ /pubmed/18447954 http://dx.doi.org/10.1186/1532-429X-10-19 Text en Copyright © 2008 Zagrosek et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Zagrosek, Anja
Wassmuth, Ralf
Abdel-Aty, Hassan
Rudolph, André
Dietz, Rainer
Schulz-Menger, Jeanette
Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title_full Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title_fullStr Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title_full_unstemmed Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title_short Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study
title_sort relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a cmr study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396625/
https://www.ncbi.nlm.nih.gov/pubmed/18447954
http://dx.doi.org/10.1186/1532-429X-10-19
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