Analysis of Clinical Parameters and Cardiac Magnetic Resonance Imaging as Predictors of Outcome in Pediatric Myocarditis

Sachdeva, Shagun; Song, Xiaoyan; Dham, Niti; Heath, Deneen M.; DeBiasi, Roberta L.

doi:10.1016/j.amjcard.2014.11.029

Cited by 92 publications

(65 citation statements)

References 29 publications

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“…High specificity of LGE for the detection of myocardial injury in myocarditis had been demonstrated in several studies (Cooper et al, 2007; Abdel-Aty et al, 2005; Mahrholdt et al, 2004). In our study, patchy mid-wall or subepicardial LGE in the LV walls were found in seven FM children (87.5%), which were similar to those in AM children (Banka et al, 2015; Sachdeva et al, 2015). Similar mid-wall LGE were also found in a 33-year-old female FM patient (Ryu et al, 2013).…”

Section: Discussionsupporting

confidence: 78%

“…CMR has been applied to predict the outcomes of AM. Sachdeva et al (2015) reported that LGE could be found in half of AM children and it could be identified as predictors of poor outcomes. Barone-Rochette et al (2014) also applied a simplified visual quantitative score of LGE to identify the outcomes of AM patients, with LGE identified as an independent predictor of all cause and cardiac mortality in these AM patients.…”

Section: Discussionmentioning

confidence: 99%

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A retrospective study: cardiac MRI of fulminant myocarditis in children—can we evaluate the short-term outcomes?

Wang

Zhao

Jia

et al. 2016

PeerJ

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BackgroundFulminant myocarditis (FM) is an inflammatory disease of the myocardium that results in ventricular systolic dysfunction and causes acute-onset heart failure. Cardiac magnetic resonance (CMR) has become the primary noninvasive tool for the diagnosis and evaluation of myocarditis. The aim of our study was to assess the CMR findings at different course of FM and the short-term outcomes of fulminant myocarditis (FM) in children.MethodsEight FM children with CMR examinations were included in our study. Initial baseline CMR was performed 10 days (range, 7–20 days) after onset of FM and follow-up CMR after 55 days (range, 33–75 days). Cardiac morphology and function and myocardial tissue characterization at baseline and follow-up CMR were compared using paired T-test and Mann–Whitney U test. The clinical data and initial CMR findings were also compared to predict short-term outcomes.ResultsThe median age of eight FM children was 8.5 years old (range, 3–14). The initial CMR findings were most common with early gadolinium enhancement (EGE, 100%), followed by signal increasing on T2WI and late gadolinium enhancement (LGE, 87.5%), increased septal thickness (75.0%) and increased left ventricle ejection fraction (LVEF, 50.0%). Only three LGE (37.5%), one signal increasing on T2WI (12.5%) and one increased LVEF (12.5%) were found at follow-up. Statistically significant differences were found between initial and follow-up CMR abnormalities in the septal thickness, left ventricular end-diastolic diameter (LVEDD), end-systolic volume (ESV), LVEF, left ventricular mass, T2 ratio and LGE area (P = 0.011, P = 0.042, P = 0.016, P = 0.001, P = 0.003, P = 0.011, P = 0.020). The children with full recovery performed higher incidence of III° atrioventricular block (AVB, five cases VS 0 case) and smaller LGE area (104.0 ± 14.5 mm2 VS 138.0 ± 25.2 mm2) at baseline CMR.DiscussionThe CMR findings of FM in children were characteristic and useful for early diagnosis. Full recovery of clinical manifestations, immunological features and CMR findings could be found in most FM children. The presence of III° AVB and smaller LGE area at baseline CMR might indicate better short-term outcomes.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

A retrospective study: cardiac MRI of fulminant myocarditis in children—can we evaluate the short-term outcomes?

Wang

Zhao

Jia

et al. 2016

PeerJ

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“…In the pediatric population, however, data are considerably more scarce. A recent single center retrospective study by Sachdeva et al sought to identify predictors of adverse outcomes in 58 children with myocarditis [27]. In the 34 patient subgroup who had CMR examinations, LGE was found in 17 (50 %), most commonly in the posterior and lateral walls of the left ventricle.…”

Section: Cardiomyopathymentioning

confidence: 99%

Cardiovascular Magnetic Resonance in Pediatric and Congenital Heart Disease: An Update on Recent Developments

Beroukhim

Powell

2015

Curr Pediatr Rep

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Cardiovascular magnetic resonance (CMR) plays an important role in the evaluation of children and adults with congenital heart disease. It provides complementary information to echocardiography and cardiac catheterization, and has unique diagnostic capabilities. Accordingly, data from CMR are increasingly being incorporated into disease management algorithms. This article critically reviews recently published reports related to pediatric and congenital CMR with sections on new techniques, congenital heart disease lesions, and cardiomyopathy.

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“…[20][21][22] However, these tests cannot be used to establish a diagnosis of myocarditis, as they lack sufficient sensitivity and specificity. Thus, in this study, we focused on the significance of serum CMLC-1 levels in the treatment of children with FM.…”

Section: Discussionmentioning

confidence: 99%

Changes in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification

Sheng

Zhang

Jia

et al. 2017

Rev. Assoc. Med. Bras.

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Sheng C et al. 904 rev assoC med bras 2017; 63(10):904-909 ORIGINAL ARTICLEChanges in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification Before and during treatment (48 and 72 hours after treatment, or death), the optical density value of serum CMLC-1 was measured using enzyme-linked immunosorbent assay, and then the serum CMLC-1 concentration was calculated.The correlations between CMLC-1 OD value change and laboratory indexes including creatine kinase-MB (CK-MB), troponin, myohemoglobin and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed. Results:The serum CMLC-1 concentration significantly increased in the children with FM and decreased obviously during CBP therapy. In the same period, the change of CMLC-1 concentration were positively correlated with creatine kinase-MB (r=0.528), troponin (r=0.726), myohemoglobin (r=0.702), and NT-proBNP levels (r=0.589). Conclusion:The serum CMLC-1 concentration increases significantly in children with FM, but CBP therapy can effectively control this increase.

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Analysis of Clinical Parameters and Cardiac Magnetic Resonance Imaging as Predictors of Outcome in Pediatric Myocarditis

Cited by 92 publications

References 29 publications

A retrospective study: cardiac MRI of fulminant myocarditis in children—can we evaluate the short-term outcomes?

A retrospective study: cardiac MRI of fulminant myocarditis in children—can we evaluate the short-term outcomes?

Cardiovascular Magnetic Resonance in Pediatric and Congenital Heart Disease: An Update on Recent Developments

Changes in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification

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