scholarly journals Cardiac magnetic resonance T2 relaxometry in acute myocarditis correlations with myocardial function and cardiac biomarkers

2015 ◽  
Vol 17 (S1) ◽  
Author(s):  
Agnes Mayr ◽  
Pierre Schanen ◽  
Andreas Loewen ◽  
Michael Schocke
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Function ◽  
Acute Myocarditis ◽  
Cardiac Biomarkers ◽  
T2 Relaxometry

scholarly journals Staphylococcus aureus Myocarditis with Associated Left Ventricular Apical Thrombus

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Michael McGee ◽  
Emily Shiel ◽  
Stephen Brienesse ◽  
Stuart Murch ◽  
Robert Pickles ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Systolic Function ◽  
Acute Myocarditis ◽  
Complete Recovery ◽  
Left Ventricular ◽  
Mural Thrombus ◽  
Intravenous Antibiotics ◽  
Discharge From Hospital

Staphylococcus aureus myocarditis is a rare diagnosis with a high mortality rate, usually seen in people who are immunocompromised. Here, we report a case of a 44-year-old man on methotrexate for rheumatoid arthritis who presented in septic shock and was diagnosed with staphylococcus aureus myocarditis. The myocarditis was associated with a left ventricular apical thrombus, with normal systolic function. The myocarditis and associated thrombus were characterised on transthoracic echocardiogram and subsequently on cardiac magnetic resonance imaging. Cardiac magnetic resonance (CMR) imaging showed oedema in the endomyocardium, consistent with acute myocarditis, associated with an apical mural thrombus. Repeat CMR 3 weeks following discharge from hospital showed marked improvement in endomyocardial oedema and complete resolution of the apical mural thrombus. He was treated with a 12-week course of antibiotics and anticoagulated with apixaban. The patient was successfully managed with intravenous antibiotics and anticoagulation with complete recovery.

scholarly journals Optimal timing of follow-up cardiac magnetic resonance in patients with acute myocarditis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Ciabatti ◽  
L Ferri ◽  
A Camporeale ◽  
E Saletti ◽  
M Chioccioli ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Complete Resolution ◽  
Time Course ◽  
Acute Myocarditis ◽  
Left Ventricular ◽  
Optimal Timing ◽  
2D Echocardiography ◽  
Prognostic Stratification

Abstract Background Cardiac magnetic resonance (CMR) plays a central role in the diagnosis, follow-up and prognostic stratification of acute myocarditis. Several CMR features, including the extent of late gadolinium enhancement (LGE) at baseline, have been proposed as factors associated with a worse outcome. Recent studies evaluated temporal evolution of LGE and edema repeating CMR either at 6 months or at 12 months, demonstrating that persistence or worsening of LGE represents a negative prognostic marker. However, the time-course of edema resolution and LGE stabilization is currently unknown and therefore the optimal timing to repeat CMR for acute myocarditis prognostic stratification remains unclear. Purpose We aimed to assess the time course of edema and LGE evolution in order to identify the optimal timing to repeat CMR in patients with acute myocarditis. Methods We enrolled 36 patients with a diagnosis of acute myocarditis according to ESC position statement definition. All patients underwent CMR at clinical presentation (CMR-1), after 3–4 months (CMR-2) and after 12-months (CMR-3) follow-up. CMR evaluation included assessment of edema and LGE, and evaluation of structural and functional parameters including left (LVEF) and right ventricular ejection fraction (RVEF), left (LVGLS) and right ventricular global longitudinal strain (RVGLS) and indexed left ventricular mass (iLVM). After CMR-3 all patients were followed-up by yearly clinical evaluation, electrocardiogram (ECG) and 2D-echocardiography. Results The mean age was 28,8±10,3 years with 35 (97%) being male. All patients showed edema and LGE at CMR-1 with a LVEF of 58,5±12,2. At CMR-2 a significant reduction of edema (T2 positive segments 0,4±0,9 vs. 4,1±3,2 p<0.0001) and LGE extent (LGE ≥5SD 5,1±5,3 vs. 9,6±8,4 p<0.0001) was observed, with only 3 patients showing edema persistence. A significant improvement of LVEF (62,7±5,6 vs. 58,5±12,2 p<0.05), RVGLS (−24,4±5,4 vs. −21,6±7,4 p<0.05), associated with a significant reduction of iLVM (71,2±13,7 vs 78,1±15,2 g/mq) was also observed. At CMR-3 no further significant reduction of LGE extent was observed with no further improvement of LVEF, RVGLS and iLVM. In the 3 patients with persisting edema at CMR-2, a complete resolution was observed at CMR-3. After a mean follow-up of 60±23 months, no major cardiovascular events nor myocarditis recurrences were observed, with no patients showing left ventricular dysfunction nor progression to dilated cardiomyopathy at 2D-echocardiography. Conclusions In most patients with acute myocarditis a complete resolution of the inflammatory process with LGE stabilization and normalization of left ventricular function and mass can be observed after 3–4 months. Further CMR assessment should limited to patients with persisting oedema at 3–4 months CMR. Our findings suggest to redefine the follow-up schedule and imaging-based prognostic stratification strategies in patients with acute myocarditis. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

scholarly journals Cardiac Involvement in Human Immunodeficiency Virus Infected Patients: An Observational Cardiac Magnetic Resonance Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chengxi Yan ◽  
Ruili Li ◽  
Xiaojuan Guo ◽  
Huan Yu ◽  
Wenhuan Li ◽  
...  
Keyword(s):  
Relaxation Time ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Fibrosis ◽  
Myocardial Function ◽  
Volume Fraction ◽  
Myocardial Inflammation ◽  
Inferior Wall ◽  
Systolic Strain ◽  
Hiv Aids

Objectives: To investigate the subclinical imaging changes in terms of myocardial inflammation and fibrosis and to explore the risk factors associated with myocardial fibrosis by cardiac magnetic resonance (CMR) approach in a Chinese HIV/AIDS cohort.Methods: We evaluated myocardial function (cine), myocardial inflammation (T1, T2), and myocardial fibrosis (through extracellular volume fraction [ECV] and late gadolinium enhancement [LGE]) by a multiparametric CMR scan protocol in a total of 68 participants, including 47 HIV-infected individuals, who were divided into two groups: asymptomatic HIV (HIV+) (n = 30), and acquired immunodeficiency syndrome (AIDS) (n = 17), and 21 healthy controls.Results: HIV-infected patients had lower left (55.3 ± 6.5 vs. 63.0 ± 7.9%, P < 0.001) and right ventricular systolic function (35.9 ± 15.7 vs. 50.8 ± 9.3%, P < 0.001). Radial systolic strain (30.7 ± 9.3 vs. 39.3 ± 9.4%, P = 0.001), circumferential systolic strain (−17.5 ± 2.6 vs. −19.4 ± 2.7%, P = 0.008), and longitudinal systolic strain (−9.4 ± 5.7 vs. −12.8 ± 3.1%, P = 0.012) were also decreased in HIV. Native T1 relaxation time (1,337.2 ± 70.2 vs. 1,249.5 ± 47.0 ms, P < 0.001), ECV value (33.5 ± 6.2 vs. 28.5 ± 2.9 ms, P = 0.026), and T2 relaxation time (45.2 ± 3.5 vs. 42.0 ± 2.6 ms, P = 0.001) were higher in HIV-infected patients compared with controls. Myocardial fibrosis, predominantly in the mid-inferior wall, was detected in 24.4% of the HIV-infected patients. HIV+ had a significantly lower value of ECV [29.1 (26.1, 31.8) vs. 35.2 (31.8, 41.9) %, P < 0.001] and frequency of LGE [3/25 (8%) vs. 7/16 (43.8%), P = 0.014)] compared with AIDS. AIDS was associated with myocardial fibrosis.Conclusions: HIV-infected patients were associated with changes in myocardial function and higher rates of subclinical myocardial inflammation and fibrosis, which were more abnormal with greater severity of the disease. AIDS was associated with myocardial fibrosis, where the observations supported earlier initiation of antiretroviral therapy in the Chinese HIV/AIDS cohort.

Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

2020 ◽  
Author(s):  
Safir Soukaina
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
Clinical Signs ◽  
Acute Onset ◽  
St Segment Elevation ◽  
The Difference

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.

P5266Renal denervation improves diastolic dysfunction in patients with HFpEF - initial results of a multicenter CMR study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Zamani ◽  
F Mahfoud ◽  
L Stoiber ◽  
M Boehm ◽  
B Pieske ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Myocardial Function ◽  
Left Ventricular ◽  
Cine Mri ◽  
Preserved Ejection Fraction

Abstract Introduction Renal denervation (RDN) significantly reduces blood pressure (BP) and improves myocardial function in patients with resistant hypertension. Purpose This multicenter study aimed to investigate the intermediate term effect of RDN on left ventricular global longitudinal strain (GLS), a surrogate for diastolic myocardial function in RDN patients with proven heart failure with preserved ejection fraction (HFpEF), assessed by cardiac magnetic resonance imaging (CMR). Methods We analyzed data from 22 patients with resistant hypertension (mean age 68±6 years). 16 patients underwent renal denervation (RDN) and 6 matched control patients received optimal medical therapy (OMT). Both groups had diastolic dysfunction defined by preserved ejection fraction (EF ≥50%) and pathologically elevated GLS at baseline (GLS >−18%) quantified by cardiac magnetic resonance (CMR). A standardized CMR protocol was performed at baseline (BL) and 6 months follow-up (FU). Left ventricular mass index (LVMI) was quantified in end-diastolic and end-systolic endo- and epicardial contouring in short axis cine-MRI images. GLS was measured by end-diastolic and end-systolic endocardial contouring in 2-, 3- and 4-chamber view cine-MRI images. MRI-Images have been analyzed with Medis, Netherlands. Results GLS following RDN patients significantly improved after 6 months by 21% (−14.21% ±3.19 vs. −17.17%± 3.1; p=0.007). In control patients with OMT, no significant change in GLS was detected (−14.77% ±3.05 vs. −17.39% ± 4.49; p=0.327). LVMI was numerically reduced in the RDN group at follow-up but did not reach statistical significance (58.55 g/m2±11.37 vs. 55.46 g/m2±12.76; p=0.085). There was no such effect in control patients with OMT (49.25 g/m2±8.2 vs. 50.18 g/m2±7.27; p=0.665). (See also: Figure A and B). Conclusions We found significantly improved diastolic function (GLS) in patients with HFpEF and resistant hypertension undergoing RDN. Future studies are needed to determine whether RDN represents a treatment option in patients with HFpEF.

scholarly journals More than 50% of non-healing at one year in “infarct-like” acute myocarditis evaluated by Cardiac Magnetic Resonance

2019 ◽  
Vol 11 (1) ◽  
pp. e299-e300
Author(s):  
T. Pommier ◽  
C. Guenancia ◽  
S. Tisserand ◽  
T. Leclercq ◽  
A. Alaa El Din ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Acute Myocarditis ◽  
One Year
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