No abstract

Highlights section Myocarditis in the course of SARS-CoV-2 infection is highly over-diagnosed. The term „myocarditis” should be used only for endomyocardial biopsy- and/or autopsy- proven diagnosis. There is still no proof that SARS-CoV-2 can cause direct cardiomyocyte damage.

Outcome predictors in myocarditis are not well defined; we aimed at identifying predictors of death, heart transplantation (HTx) and relapse before the introduction of immunosuppression.

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Ducci, C. (2019). Native T1 mapping to detect extent of acute and chronic myocardial infarction: comparison with late gadolinium enhancement technique. Abstract Aim:Investigate whether native-T1 mapping can assess the transmural extent of myocardial infarction(TEI) thereby differentiating viable from non-viable myocardium without the use of gadolinium-contrast in both acute and chronic myocardial infarction(aMI and cMI). METHODS:60patients (30 cMI>1year and 30 aMI day2 STEMI) and 20 healthy-controls underwent 1.5T CMR to assess left ventricular function(cine), native-T1 mapping(MOLLI sequence 5(3)3, motion-corrected) and the presence and TEI from late gadolinium enhancement(LGE) images. Segments with <75% TEI was considered viable. Gold-standard LGE-TEI was compared with corresponding segmental native-T1. RESULTS:Segmental native-T1 correlated significantly with TEI(R= 0.74,p<0.001 in cMI and R=0.57,p<0.001 in aMI). Native-T1 differentiated segments with no LGE(1031±31ms), LGE positive but viable(1103±57ms) and LGE positive but non-viable(1206±118ms) in cMI(p<0.01). It also differentiated segments with no LGE(1054±65m), LGE positive but viable(1135±73ms) and LGE positive but non-viable(1168±71ms) in aMI(p<0.01). ROC analysis demonstrated excellent accuracy of native-T1 mapping compared to LGE-TEI(AUC-0.88,p <0.001 in cMI, vs AUC -0.83,p<0.001 in aMI). Native-T1 performed better in cMI than aMI(p<0.01). In cMI a segmental T1 threshold of 1085ms differentiated viable from nonviable segments with a sensitivity 88% and specificity of 88% whereas a T1 of 1110ms differentiated viable from nonviable with 79% sensitivity and 79% specificity in aMI. CONCLUSIONS:Native-T1 mapping correlates significantly with TEI thereby differentiating between normal, viable, and non-viable myocardium with distinctive T1 profiles in aMI and cMI. Native T1mapping to detect MI performed better in cMI compared to aMI due to absence of myocardial oedema. Native-T1 mapping holds promise for viability assessment without the need for gadolinium-contrast agent.