Diagnostic and prognostic value of cardiac magnetic resonance in acute myocarditis: a systematic review and meta-analysis

Blissett, Sarah; Chocron, Yehuda; Kovacina, Bojan; Afilalo, Jonathan

doi:10.1007/s10554-019-01674-x

Cited by 28 publications

(20 citation statements)

References 62 publications

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“… 50 The presence and location in the mid layer of the septum (mid-wall strip) of LGE and low LVEF at baseline appear to be the strongest negative predictors of outcome. 17 , 51 CMRI is useful also in the follow-up of AM and is generally performed 6 to 12 months after the index event (Table 3 ). Disappearance of edema is frequent at follow-up (up to 84% of cases), whereas LGE generally persists (in up to 89%), although its extent is reduced from 6.2% to 4.1% of LV mass after 6 months in the Italian Multicenter Study on Acute Myocarditis registry including 187 cases.…”

Section: Diagnostic Approach To Am and Infl-cmpmentioning

confidence: 99%

Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy

Ammirati

Frigerio

Adler

et al. 2020

Circ: Heart Failure

448

601

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Myocarditis is an inflammatory disease of the heart that may occur because of infections, immune system activation, or exposure to drugs. The diagnosis of myocarditis has changed due to the introduction of cardiac magnetic resonance imaging. We present an expert consensus document aimed to summarize the common terminology related to myocarditis meanwhile highlighting some areas of controversies and uncertainties and the unmet clinical needs. In fact, controversies persist regarding mechanisms that determine the transition from the initial trigger to myocardial inflammation and from acute myocardial damage to chronic ventricular dysfunction. It is still uncertain which viruses (besides enteroviruses) cause direct tissue damage, act as triggers for immune-mediated damage, or both. Regarding terminology, myocarditis can be characterized according to etiology, phase, and severity of the disease, predominant symptoms, and pathological findings. Clinically, acute myocarditis (AM) implies a short time elapsed from the onset of symptoms and diagnosis (generally <1 month). In contrast, chronic inflammatory cardiomyopathy indicates myocardial inflammation with established dilated cardiomyopathy or hypokinetic nondilated phenotype, which in the advanced stages evolves into fibrosis without detectable inflammation. Suggested diagnostic and treatment recommendations for AM and chronic inflammatory cardiomyopathy are mainly based on expert opinion given the lack of well-designed contemporary clinical studies in the field. We will provide a shared and practical approach to patient diagnosis and management, underlying differences between the European and US scientific statements on this topic. We explain the role of histology that defines subtypes of myocarditis and its prognostic and therapeutic implications.

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Section: Diagnostic Approach To Am and Infl-cmpmentioning

confidence: 99%

Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy

Ammirati

Frigerio

Adler

et al. 2020

Circ: Heart Failure

448

601

View full text Add to dashboard Cite

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“…CMR has been increasingly used in acute cardiovascular diseases such as acute coronary syndrome and acute myocarditis, facilitating risk stratification with myocardial tissue characterization [ 90 , 91 ]. In the context of acute CRS, one study demonstrated an association between microvascular myocardial injury assessed by contrast-enhanced CMR and increased risk of AKI in patients with ST-elevation myocardial infarction [ 92 ].…”

Section: Application Of Imaging Biomarkers In Acute Crsmentioning

confidence: 99%

Cardiorenal Syndrome: Emerging Role of Medical Imaging for Clinical Diagnosis and Management

Lin

Zhou

Dekkers

et al. 2021

JPM

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Cardiorenal syndrome (CRS) concerns the interconnection between heart and kidneys in which the dysfunction of one organ leads to abnormalities of the other. The main clinical challenges associated with cardiorenal syndrome are the lack of tools for early diagnosis, prognosis, and evaluation of therapeutic effects. Ultrasound, computed tomography, nuclear medicine, and magnetic resonance imaging are increasingly used for clinical management of cardiovascular and renal diseases. In the last decade, rapid development of imaging techniques provides a number of promising biomarkers for functional evaluation and tissue characterization. This review summarizes the applicability as well as the future technological potential of each imaging modality in the assessment of CRS. Furthermore, opportunities for a comprehensive imaging approach for the evaluation of CRS are defined.

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“…The prognosis of patients with “infarct-like” myocarditis is dubious: Some authors[ 30 ] reported an association between the infarct-like pattern and major cardiovascular events, while others[ 23 ] stated a positive evolution with a good prognosis. However, the presence of LV dysfunction at baseline and of LGE predicts patients at high risk of adverse events[ 31 ]. There are not yet consistent data on the prognostic role of mapping technique, mainly due to recent introduction in clinical practice.…”

Section: Acute Myocarditismentioning

confidence: 99%

Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: A review

Gatti

Carisio

D’Angelo

et al. 2020

WJC

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The diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) necessitates documentation of an acute myocardial infarction (AMI), non-obstructive coronary arteries, using invasive coronary angiography or coronary computed tomography angiography and no clinically overt cause for AMI. Historically patients with MINOCA represent a clinical dilemma with subsequent uncertain clinical management. Differential diagnosis is crucial to choose the best therapeutic option for ischemic and non-ischemic MINOCA patients. Cardiovascular magnetic resonance (CMR) is able to analyze cardiac structure and function simultaneously and provides tissue characterization. Moreover, CMR could identify the cause of MINOCA in nearly two-third of patients providing valuable information for clinical decision making. Finally, it allows stratification of patients with worse outcomes which resulted in therapeutic changes in almost half of the patients. In this review we discuss the features of CMR in MINOCA; from exam protocols to imaging findings.

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Diagnostic and prognostic value of cardiac magnetic resonance in acute myocarditis: a systematic review and meta-analysis

Cited by 28 publications

References 62 publications

Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy

Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy

Cardiorenal Syndrome: Emerging Role of Medical Imaging for Clinical Diagnosis and Management

Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: A review

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