Diagnostic role of strain imaging in atypical myocarditis by echocardiography and cardiac MRI

Wisotzkey, Bethany; Soriano, Brian D.; Albers, E.; Ferguson, Mark; Buddhe, Sujatha

doi:10.1007/s00247-017-4061-0

Cited by 22 publications

(27 citation statements)

References 37 publications

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“…Cardiac MRI, a multi-directional approach in patients with clinically suspected acute myocarditis, is reported to be quite sensitive and specific in differentiating it from other myocardial diseases, especially for ischemic coronary disease [13]. EGE is useful in evaluating capillary leakage and microcirculatory disturbance, as well as for establishing etiology, quantification, identifying prognostic factors, regular follow-up, and assessment of treatment response in myocarditis [14]. The comprehensive diagnosis of myocarditis was based on clinical symptoms, coronary angiography, ECG, laboratory examination, and clinical follow-up [15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Early Gadolinium Enhancement (EGE) and Cardiac Functional Parameters in Cine-Magnetic Resonance Imaging (MRI) on Artificial Intelligence in Patients with Acute Myocarditis: A Case-Controlled Observational Study

Yuan

Zhao

et al. 2019

Med Sci Monit

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Background The diagnosis of myocarditis is challenging, and the treatment is generally delayed due to misdiagnosis or missed diagnosis. Endomyocardial biopsy (EMB) is not a specific or sensitive method. A case-controlled observational study was conducted to evaluate early gadolinium enhancement (EGE) and left ventricular functional parameters on Artificial Intelligence in cine-MRI in patients with acute myocarditis. Material/Methods We selected 21 patients with pathologically proven acute myocarditis. We analyzed the EGE findings (total/serial number and location of positive-segments using the 17-segment model according to the American Heart Association) and clinical characteristics (symptoms, arrhythmias in ECG, coronary angiography, and EMB). All patients were divided into positive EGE and negative EGE groups to analyze left ventricular functional parameters (LVEF, FS, LVEDD, LVEDV, LVESV, LVMM, LVSV, CO, and CI) on Artificial Intelligence. Results We enrolled 21 patients (11 males) with a mean age of 32.6±9.8 years (range, 16 to 51 years). Abnormalities on EGE were found in 2/3 of patients, involving 41 segments among multiple locations on the myocardium. The differences in LVEF (40.2±10.2% vs. 51.3±3.6%), LVESV (69.0±16.1ml vs. 52.5±10.6ml) and LVSV (42.6±11.4 vs. 52.8±2.8 ml) on Artificial Intelligence was statistically significant between the positive EGE and negative EGE groups (p<0.05). Conclusions Our results suggest a significant role of EGE on the basis of Lake Louise criteria in evaluating patients with clinical suspicion of acute myocarditis. Parameters, including LVEF, LVESV, and LVSV, on Artificial Intelligence, may be useful independent predictors for capillary leakage and microcirculatory disturbance in myocarditis.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Early Gadolinium Enhancement (EGE) and Cardiac Functional Parameters in Cine-Magnetic Resonance Imaging (MRI) on Artificial Intelligence in Patients with Acute Myocarditis: A Case-Controlled Observational Study

Yuan

Zhao

et al. 2019

Med Sci Monit

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“…A strain echocardiography was performed by the same manipulator. It is to be mentioned that we used this method as it is cheap, available in our hospital, proved to be able to detect subtle functional changes that are not revealed by standard echocardiography, 13 and that cardiac MRI is not available in our hospital.…”

Section: Methodsmentioning

confidence: 99%

Scorpion sting: N-terminal fragment of proB-type natriuretic peptide as an early predictor of pediatric cardiotoxicity

2020

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Aim of the work: This prospective study was conducted to evaluate the clinical reliability of N-terminal fragment of proB-type natriuretic peptide (NT-proBNP) in identifying patients with cardiotoxicity in the early hours following scorpion sting. Subjects and methods: This study involved 483 children aging between 2–17 years who were admitted to Minia University Poisoning Control Center from 1st January 2010 to 31st December 2019 with a history of scorpion sting, and on clinical evaluation symptoms were manifested. All subjects were clinically examined, investigated for NT-proBNP and CPK-MB on admission, 6 h and 24 h post-envenomation; and subjected to 24 h cardiac monitoring with periodic ECG every 6 h. Results: Assessment of CPK-MB levels showed a significant increase in all moderate to severe cases 6 h post-envenomation. Assessment of NT-proBNP levels showed a significant increase in all moderate to severe cases on admission and 6 h post-envenomation. Moreover, there was a significant decrease in the NT-proBNP level after 24 h compared with that measured on admission. The sensitivity of NT-proBNP for the diagnosis of myocardial injury at hospital admission was significantly higher than that of CPK-MB. Conclusion: NT-proBNP may be a valuable and sensitive laboratory biomarker to predict cardiotoxicity of scorpion sting in the early hours.

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“…1 It is usually associated with pericardial impairment, but cardiac function is normal. 32 In these patients, it is necessary to ensure that coronaries do not have congenital or acquired anatomical abnormalities through imaging tests such as echocardiogram and coronary computed tomography angiography.…”

Section: Review Articlementioning

confidence: 99%

“…Although most children may recover atrioventricular conduction, some patients may require permanent pacemaker implantation. [32][33][34]…”

Section: Arrhythmiasmentioning

confidence: 99%

Acute Myocarditis in Childhood and Adolescence in the Covid-19 Era

Torbey¹,

Souza²,

Bustamante³

et al. 2021

ABC: Heart Failure &Amp; Cardiomyopathy

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Myocarditis in children and adolescents is an inflammatory myocardial disease with a heterogeneous presentation ranging from oligosymptomatic, with no impaired ejection fraction to catastrophic clinical presentation with cardiogenic shock (fulminant myocarditis) or sudden death. Thus, this condition remains a major challenge from the diagnostic and therapeutic points of view. Despite the different etiologies listed, the most frequent form may be related to viral diseases, and new forms of myocarditis, such allergic ones (eosinophilic and use of medications, particularly cancer immunotherapy), have been currently described. Increasing the rate of suspicion is crucial. Measurement of serum levels of troponin and N-terminal B-type natriuretic peptide, as well as the use of advanced methods of cardiac imaging, such as strain echocardiogram, positron emission tomography, and cardiac magnetic resonance, are integral part of multimodal assessment in suspected patients. Although endomyocardial biopsy remains is still the gold standard for disease diagnosis, currently it tends to be performed in specific situations, such as fulminant clinical presentation and chronic or recurrent myocarditis. The management of this condition includes general supportive care, treatment of heart failure, control of arrhythmias when present, assessment of mechanical support and cardiac transplantation. Treatments based on immunosuppression and immunotherapy are still controversial. In this article, we propose a broad review of diagnostic and treatment methods, as well as the different etiologies in the pediatric population.

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Diagnostic role of strain imaging in atypical myocarditis by echocardiography and cardiac MRI

Cited by 22 publications

References 37 publications

Evaluation of Early Gadolinium Enhancement (EGE) and Cardiac Functional Parameters in Cine-Magnetic Resonance Imaging (MRI) on Artificial Intelligence in Patients with Acute Myocarditis: A Case-Controlled Observational Study

Evaluation of Early Gadolinium Enhancement (EGE) and Cardiac Functional Parameters in Cine-Magnetic Resonance Imaging (MRI) on Artificial Intelligence in Patients with Acute Myocarditis: A Case-Controlled Observational Study

Scorpion sting: N-terminal fragment of proB-type natriuretic peptide as an early predictor of pediatric cardiotoxicity

Acute Myocarditis in Childhood and Adolescence in the Covid-19 Era

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