Association between ECG parameters and late gadolinium enhancement along the course of myocarditis.

Autor: Károlyi M; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Kolossváry M; Gottsegen National Cardiovascular Center, Budapest, Hungary., Weber L; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland., Matziris I; Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Polacin M; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland., Sokolska JM; Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland., Gotschy A; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland., Alkadhi H; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Manka R; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Robert.Manka@usz.ch.; Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Robert.Manka@usz.ch.; Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland. Robert.Manka@usz.ch.; Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. Robert.Manka@usz.ch.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2023 Jun; Vol. 39 (6), pp. 1169-1178. Date of Electronic Publication: 2023 Feb 24.
DOI: 10.1007/s10554-023-02811-3
Abstrakt: Purpose: Numerous electrocardiogram (ECG) abnormalities and late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (CMR) have been related to poor prognosis in acute myocarditis. We evaluated whether ECG parameters are associated with the distribution and dynamic of LGE along the course of myocarditis.
Methods: Fifty-one patients with CMR confirmed acute myocarditis were included who underwent CMR with LGE and 12-lead ECG at baseline and 3-month follow-up at our institution. The association between the presence, regional distribution and change of ECG parameters and LGE was investigated using linear regression analysis. LGE was quantified as visual presence score (VPS) and visual transmurality score (VTS).
Results: Among many ECG parameters only > 1 mm ST-elevation (STE) was associated with VPS and VTS at baseline (β = 3.08 [95%CI: 1.75; 4.41], p = < 0.001 and β = 5.40 [95%CI: 1.92; 8.88], p = 0.004; respectively). STE was most frequent in lateral and inferior ECG-leads (48% and 31%) and it was associated with VPS and VTS in these localizations (p < 0.05 all), however no association between anterior-septal STE and LGE could be confirmed. At follow-up the regression of STE was associated with the regression of VPS and VTS in univariate analysis (β=-1.49 [95%CI: -2.41; -0.57], p = 0.003 and β=-4.87 [95%CI: -7.18; -2.56], p = 0.001, respectively), which remained significant for VTS using a multivariate model (β=-2.39 [95%CI: -3.32; -0.47], p = 0.019).
Conclusion: Although we demonstrated some promising associations between STE and LGE, the usability of ECG to estimate the territorial involvement and dynamical changes of LGE along the course of myocarditis is generally limited and cardiac magnetic resonance should be considered for this purpose.
(© 2023. The Author(s).)
Databáze: MEDLINE
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