The utility of cardiac magnetic resonance imaging in the diagnosis of adult patients with acute myocarditis: a systematic review and meta-analysis

Khanna, S.; Amarasekera, A.; Li, Cindy; Bhat, A.; Chen, Henry H.L.; Gan, G.; Tan, Timothy C.

doi:10.1016/j.ijcard.2022.06.047

Cited by 9 publications

(4 citation statements)

References 66 publications

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“…Performing ECV in addition to T 2 improved the specificity. This result supports the approach that T 1 -based ECV and T 2 mapping have complementary diagnostic value as reflected by current expert recommendations for the diagnostic management of patients with suspected myocarditis [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 82%

Comprehensive Cardiac Magnetic Resonance to Detect Subacute Myocarditis

Brendel

Klingel

Kübler

et al. 2022

JCM

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(1) Background: Compared to acute myocarditis in the initial phase, detection of subacute myocarditis with cardiac magnetic resonance (CMR) parameters can be challenging due to a lower degree of myocardial inflammation compared to the acute phase. (2) Objectives: To systematically evaluate non-invasive CMR imaging parameters in acute and subacute myocarditis. (3) Methods: 48 patients (age 37 (IQR 28–55) years; 52% female) with clinically suspected myocarditis were consecutively included. Patients with onset of symptoms ≤2 weeks prior to 1.5T CMR were assigned to the acute group (n = 25, 52%), patients with symptom duration >2 to 6 weeks were assigned to the subacute group (n = 23, 48%). CMR protocol comprised morphology, function, 3D-strain, late gadolinium enhancement (LGE) imaging and mapping (T1, ECV, T2). (4) Results: Highest diagnostic performance in the detection of subacute myocarditis was achieved by ECV evaluation either as single parameter or in combination with T1 mapping (applying a segmental or global increase of native T1 > 1015 ms and ECV > 28%), sensitivity 96% and accuracy 91%. Compared to subacute myocarditis, acute myocarditis demonstrated higher prevalence and extent of LGE (AUC 0.76) and increased T2 (AUC 0.66). (5) Conclusions: A comprehensive CMR approach allows reliable diagnosis of clinically suspected subacute myocarditis. Thereby, ECV alone or in combination with native T1 mapping indicated the best performance for diagnosing subacute myocarditis. Acute vs. subacute myocarditis is difficult to discriminate by CMR alone, due to chronological connection and overlap of pathologic findings.

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Section: Discussionsupporting

confidence: 82%

Comprehensive Cardiac Magnetic Resonance to Detect Subacute Myocarditis

Brendel

Klingel

Kübler

et al. 2022

JCM

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“…MRI is a non-invasive imaging technology that can observe various large blood vessels, pericdial disease and cardiomyopathy, such as primary cardiomyopathy, hypertension, aortic valve lesions, aneurysms, constrictive pericarditis and so on [ 12 ]. Previous studies [ 19 – 21 ] demonstrated that ECHO and cardiac MRI had equivalent values in the diagnosis of ventricular function. Liu et al [ 14 ] found a good correlation and consistency between the two methods in terms of left ventricular systolic function evaluation.…”

Section: Discussionmentioning

confidence: 99%

Value of Echocardiography and Cardiac Magnetic resonance in assessing left ventricular function in breast and gastric cancer patients after Anthracycline Chemotherapy

Jin,

Shi,

Wang

et al. 2023

BMC Cardiovasc Disord

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Background Echocardiography (ECHO) and cardiac magnetic resonance imaging (MRI) are used to observe changes in the left ventricular structure in patients with breast and gastric cancer after 6 cycles of chemotherapy. Based on the observed values, we aimed to evaluate the cardiotoxicity of anthracyclines in cancer patients and to analyze the consistency of the two examination methods in assessing left ventricular function after chemotherapy. Methods From January 2020 to January 2022, the data of 80 patients with malignant tumors who received anthracycline chemotherapy (breast cancer, n = 40; gastric cancer, n = 40) and 40 healthy volunteers (Control group) were retrospectively collected. Serum high-sensitivity cardiac troponin T (hs-cTnT) levels were detected by an automatic immunoassay analyzer. Left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were measured by cardiac MRI and 2-dimensional ECHO using the biplane Simpson’s method. Results Compared with baseline values, serum high-sensitivity cardiac troponin T (hs-cTnT) levels were significantly increased in patients with breast cancer and gastric cancer after 6 cycles of chemotherapy (P < 0.05). In addition, LVEDV, LVESV and LVEF measured with MRI were higher than those detected by ECHO in cancer patients after 6 cycles of chemotherapy (P < 0.05). And the Bland-Altman plot analysis showed that LVEDV, LVESV and LVEF measured by the two examination methods were in good agreement. Conclusion Breast and gastric cancer patients exhibited elevated levels of hs-cTnT after 6 cycles of chemotherapy, indicating potential cardiotoxicity. Additionally, cardiac MRI and 2-dimensional ECHO showed good agreement in assessing left ventricular function, with ECHO tending to underestimate volume measurements compared to MRI.

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“…Therefore, it is critical to determine individuals with cardiac involvement as soon as possible so that they can receive cardioprotective therapy and the proper follow-up measures. Nevertheless, similar complications did not occur in patients who had been vaccinated for COVID-19 [ 78 ].…”

Section: Reviewmentioning

confidence: 99%

Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature

Paruchuri,

Farwa,

Jabeen

et al. 2023

Cureus

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The repercussions of coronavirus disease 2019 (COVID-19) have been devastating on a global scale. Long COVID, which affects patients for weeks or even months after their initial infection, is not limited to individuals with severe symptoms and can affect people of all ages. The condition can impact various physiological systems, leading to chronic health conditions and long-term disabilities that present significant challenges for healthcare systems worldwide. This review explores the link between long COVID and cardiovascular complications such as myocardial injury and myocarditis. It also highlights the prevalence of these complications and identifies risk factors for their development in long COVID patients. Myocardial injury occurs due to direct cellular damage and T-cell-mediated cytotoxicity resulting in elevated cardiac biomarkers. Diagnostic techniques like electrocardiogram, troponin level testing, and magnetic resonance imaging can help identify myocarditis, but endomyocardial biopsy is considered the gold-standard diagnostic technique. Guideline-directed medical therapy is recommended for COVID-19 myocarditis patients for better prognosis while being monitored under comprehensive care management approaches. Therefore, it's critical to develop effective screening techniques specifically for vulnerable populations while conducting further research that addresses the effects of long COVID on society's physical health.

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The utility of cardiac magnetic resonance imaging in the diagnosis of adult patients with acute myocarditis: a systematic review and meta-analysis

Cited by 9 publications

References 66 publications

Comprehensive Cardiac Magnetic Resonance to Detect Subacute Myocarditis

Comprehensive Cardiac Magnetic Resonance to Detect Subacute Myocarditis

Value of Echocardiography and Cardiac Magnetic resonance in assessing left ventricular function in breast and gastric cancer patients after Anthracycline Chemotherapy

Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature

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