Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study
Authors' conclusion
CMR reliably identifies pericardial inflammation in patients not meeting clinical criteria and excludes significant inflammation in a large proportion of patients with an initial clinical diagnosis. CRP level and the presence of pericardial effusion may help identify patients who are likely to have CMR evidence of pericarditis.
Study context
- Population
- Consecutive patients referred for the evaluation of pericarditis by cardiac magnetic resonance (CMR) between 2010 and 2024 to a tertiary hospital in Sydney, Australiareferrals for pericarditis/myopericarditis among 2530 patients referred for CMR
- Participants
- 88 patients
- Exposure
- Patients stratified according to the presence (CMR-pos) or absence (CMR-neg) of pericardial late gadolinium enhancement (LGE), analysed for differences in clinical patterns, C reactive protein (CRP), troponin and imaging findings
- CMR-posn = 43
- CMR-negn = 45
Methodological detailsconsecutive patients, tertiary hospital in Sydney, Australia
- Consecutive patients
- Tertiary hospital in Sydney, Australia
Main finding
As reported in the abstract
CMR-proven pericarditis
CMR-proven pericarditis
43/88
49%
No CMR-proven pericarditis
45/88
51%
Observational data: associations, not effects.
Further findings
| Outcome | CMR-pos | CMR-neg |
|---|---|---|
| 2015 ESC diagnostic criteria | did not meet 2015 ESC diagnostic criteria 30% | met criteria for a clinical diagnosis 47% |
- CRP and pericardial effusion by severity of pericardial LGE: moderate/severe pericardial LGE CRP 178 mg/L (IQR 98-253) · pericardial effusion 88%
- CRP and pericardial effusion by severity of pericardial LGE: minimal/mild pericardial LGE CRP 35 mg/L (IQR 7-63) · pericardial effusion 19%
- CRP and pericardial effusion by severity of pericardial LGE: p<0.05 for both
CRP for identifying CMR-pos scans
- Sensitivity for CRP levels above 50 mg/L
- 56%
- Specificity for CRP levels above 50 mg/L
- 84%
- Moderate predictive value
CMR-pos patients not meeting clinical criteria vs clinically apparent pericarditis
- Tended to have more subacute and non-idiopathic disease despite similar levels of pericardial LGE
Original publication
Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study. Heart. Published 23 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it