Diagnostic implications of magnetic resonance feature tracking derived myocardial strain parameters in patients with clinically suspected acute myocarditis but inconspicuous CMR

Congress:

ESCR 2015

Poster Number:

P-0003

Type:

Scientific Poster

Keywords:

Cardiac, MR-Functional imaging, Computer Applications-Detection, diagnosis, Inflammation

Authors:

B. Baeßler¹, G. Michels¹, F. Schaarschmidt², A. Dick¹, D. Maintz³, A. Bunck¹; ¹Cologne/DE, ²Hannover/DE, ³Köln/DE

DOI:

DOI-Link:

https://dx.doi.org/

Fig. 2: Box-Whisker plots representing the differences of LV global longitudinal...

Fig. 3: ROC-curves of selected strain parameters for differentiating healthy volunteers...

Fig. 1: Exemplary Segmentation of LV (upper row) and RV (lower row) for Feature...

Purpose

The purpose of the present study was to evaluate the diagnostic value of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain-analysis of the left and right ventricle in patients with clinically diagnosed acute myocarditis (ACM) but inconspicuous CMR.

Methods and Materials

CMR data (Achieva 1.5T, Philips Healthcare, Best, The Netherlands) of 21 patients clinically diagnosed with ACM according to the current recommendations given by the position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases 1 were retrospectively analyzed. All patients demonstrated inconspicuous CMR findings without any wall motion abnormalities, signs of edema or early and late gadolinium enhancement (negative Lake Louise criteria 2). 30 age-matched healthy volunteers (HV) served as a control. Analysis of global longitudinal, circumferential and radial strain...

Results

ACM patients showed significantly impaired LV longitudinal strain (-14.9 ± 5.3 vs. -17.3 ± 5.6 %, p = .002) and LV circumferential strain values (-26.2 ± 3.9 vs. -27.9 ± 4.45, p = .007) compared to HV (Figure 2). Conversely, ACM patients showed a significantly improved basal RV circumferential SR (-0.80 ± 0.37 vs. -0.57 ± 0.32 s-1, p = .032; Figure 1). In a multiple logistic regression model, LV circumferential strain (B = 0.29, SE = 0.11, p = .006) and RV basal circumferential...

Conclusion

LV circumferential strain and RV basal circumferential SR are the best predictors for the presence of ACM when other CMR findings of ACM are lacking. These observations could lead to potential novel noninvasive diagnostic tools in the setting of ACM that need validation in further studies with larger patient cohorts.

References

1.Caforio ALP, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss H-P, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. European heart journal. 2013;34:2636–2648. 2.Friedrich MG, Sechtem U, Schulz-Menger...