Prognostic Value of Right Ventricular Function in Patients With Suspected Myocarditis Undergoing Cardiac Magnetic Resonance
| Autor: | Benedikt Bernhard, Aaron Schnyder, Davide Garachemani, Kady Fischer, Giulin Tanner, Yasaman Safarkhanlo, Anselm W. Stark, Jonathan Schütze, Maryam Pavlicek-Bahlo, Simon Greulich, Caroline Johner, Andreas Wahl, Dominik C. Benz, Raymond Y. Kwong, Christoph Gräni |
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| Přispěvatelé: | University of Zurich, Gräni, Christoph |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Adult
Magnetic Resonance Spectroscopy Contrast Media Magnetic Resonance Imaging Cine Stroke Volume Gadolinium 610 Medicine & health 10181 Clinic for Nuclear Medicine Middle Aged Prognosis Ventricular Function Left 2705 Cardiology and Cardiovascular Medicine Myocarditis Predictive Value of Tests Ventricular Function Right 10209 Clinic for Cardiology Humans 2741 Radiology Nuclear Medicine and Imaging Radiology Nuclear Medicine and imaging Cardiomyopathies Cardiology and Cardiovascular Medicine |
| Popis: | Risk-stratification of myocarditis is based on functional parameters and tissue characterization of the left ventricle (LV), whereas right ventricular (RV) involvement remains mostly unrecognized.In this study, the authors sought to analyze the prognostic value of RV involvement in myocarditis by cardiac magnetic resonance (CMR).Patients meeting the recommended clinical criteria for suspected myocarditis were enrolled at 2 centers. Exclusion criteria were the evidence of coronary artery disease, pulmonary artery hypertension or structural cardiomyopathy. Biventricular ejection fraction, edema according to T2-weighted images, and late gadolinium enhancement (LGE) were linked to a composite end point of major adverse cardiovascular events (MACE), including heart failure hospitalization, ventricular arrhythmia, recurrent myocarditis, and death.Among 1,125 consecutive patients, 736 (mean age: 47.8 ± 16.1 years) met the clinical diagnosis of suspected myocarditis and were followed for 3.7 years. Signs of RV involvement (abnormal right ventricular ejection fraction [RVEF], RV edema, and RV-LGE) were present in 188 (25.6%), 158 (21.5%), and 92 (12.5%) patients, respectively. MACE occurred in 122 patients (16.6%) and was univariably associated with left ventricular ejection fraction (LVEF), LV edema, LV-LGE, RV-LGE, RV edema, and RVEF. In a series of nesting multivariable Cox regression models, the addition of RVEF (HRThis study emphasizes the role of RV involvement in myocarditis and demonstrates the independent and incremental prognostic value of RVEF beyond clinical variables, CMR tissue characterization, and LV function. (Inflammatory Cardiomyopathy Bern Registry [FlamBER]; NCT04774549; CMR Features in Patients With Suspected Myocarditis [CMRMyo]; NCT03470571). |
| Databáze: | OpenAIRE |
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