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Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis

BACKGROUND: While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to in...

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Autores principales: Spieker, Maximilian, Haberkorn, Sebastian, Gastl, Mareike, Behm, Patrick, Katsianos, Stratis, Horn, Patrick, Jacoby, Christoph, Schnackenburg, Bernhard, Reinecke, Petra, Kelm, Malte, Westenfeld, Ralf, Bönner, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370450/
https://www.ncbi.nlm.nih.gov/pubmed/28351402
http://dx.doi.org/10.1186/s12968-017-0350-x
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author Spieker, Maximilian
Haberkorn, Sebastian
Gastl, Mareike
Behm, Patrick
Katsianos, Stratis
Horn, Patrick
Jacoby, Christoph
Schnackenburg, Bernhard
Reinecke, Petra
Kelm, Malte
Westenfeld, Ralf
Bönner, Florian
author_facet Spieker, Maximilian
Haberkorn, Sebastian
Gastl, Mareike
Behm, Patrick
Katsianos, Stratis
Horn, Patrick
Jacoby, Christoph
Schnackenburg, Bernhard
Reinecke, Petra
Kelm, Malte
Westenfeld, Ralf
Bönner, Florian
author_sort Spieker, Maximilian
collection PubMed
description BACKGROUND: While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to increase diagnostic accuracy. However, prognostic implications of T2 values in this cohort are unknown. The purpose of the study was to investigate the prognostic relevance of elevated CMR T2 values in patients with sAMC. METHODS AND RESULTS: We carried out a prospective study in 46 patients with sAMC defined by current ESC recommendations. A combined endpoint was defined by the occurrence of at least one major adverse cardiac event (MACE) and hospitalisation for heart failure. Event rate was 24% (n = 11) for 1-year-MACE and hospitalisation. A follow-up after 11 ± 7 months was performed in 98% of the patients. Global T2 values were significantly increased at acute stage of disease compared to controls and decreased over time. During acute disease, elevated global T2 time (odds ratio 6.3, p < 0.02) as well as myocardial fraction with T2 time >80 ms (odds ratio 4.9, p < 0.04) predicted occurrence of the combined endpoint. Patients with clinical recovery revealed significantly decreased T2 relaxation times at follow-up examinations; however, T2 values were still elevated compared to healthy controls. CONCLUSION: Assessment of myocardial T2 relaxation times at initial presentation facilitates CMR-based risk stratification in patients with acute myocarditis. T2 Mapping may emerge as a new tool to monitor inflammatory myocardial injuries during the course of disease.
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spelling pubmed-53704502017-03-30 Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis Spieker, Maximilian Haberkorn, Sebastian Gastl, Mareike Behm, Patrick Katsianos, Stratis Horn, Patrick Jacoby, Christoph Schnackenburg, Bernhard Reinecke, Petra Kelm, Malte Westenfeld, Ralf Bönner, Florian J Cardiovasc Magn Reson Research BACKGROUND: While most patients recover from suspected acute myocarditis (sAMC) some develop progressive disease with 5-year mortality up to 20%. Recently, parametric Cardiovascular Magnetic Resonance (CMR) approaches, quantifying native T1 and T2 relaxation time, have demonstrated the ability to increase diagnostic accuracy. However, prognostic implications of T2 values in this cohort are unknown. The purpose of the study was to investigate the prognostic relevance of elevated CMR T2 values in patients with sAMC. METHODS AND RESULTS: We carried out a prospective study in 46 patients with sAMC defined by current ESC recommendations. A combined endpoint was defined by the occurrence of at least one major adverse cardiac event (MACE) and hospitalisation for heart failure. Event rate was 24% (n = 11) for 1-year-MACE and hospitalisation. A follow-up after 11 ± 7 months was performed in 98% of the patients. Global T2 values were significantly increased at acute stage of disease compared to controls and decreased over time. During acute disease, elevated global T2 time (odds ratio 6.3, p < 0.02) as well as myocardial fraction with T2 time >80 ms (odds ratio 4.9, p < 0.04) predicted occurrence of the combined endpoint. Patients with clinical recovery revealed significantly decreased T2 relaxation times at follow-up examinations; however, T2 values were still elevated compared to healthy controls. CONCLUSION: Assessment of myocardial T2 relaxation times at initial presentation facilitates CMR-based risk stratification in patients with acute myocarditis. T2 Mapping may emerge as a new tool to monitor inflammatory myocardial injuries during the course of disease. BioMed Central 2017-03-29 /pmc/articles/PMC5370450/ /pubmed/28351402 http://dx.doi.org/10.1186/s12968-017-0350-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Spieker, Maximilian
Haberkorn, Sebastian
Gastl, Mareike
Behm, Patrick
Katsianos, Stratis
Horn, Patrick
Jacoby, Christoph
Schnackenburg, Bernhard
Reinecke, Petra
Kelm, Malte
Westenfeld, Ralf
Bönner, Florian
Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title_full Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title_fullStr Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title_full_unstemmed Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title_short Abnormal T2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
title_sort abnormal t2 mapping cardiovascular magnetic resonance correlates with adverse clinical outcome in patients with suspected acute myocarditis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370450/
https://www.ncbi.nlm.nih.gov/pubmed/28351402
http://dx.doi.org/10.1186/s12968-017-0350-x
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