Heart failure & cardiomyopathiesDiagnostic or prognostic study
Multiparametric Cardiac Magnetic Resonance Imaging to Discriminate Endomyocardial Biopsy-Proven Chronic Myocarditis From Healed Myocarditis
- Diagnostic accuracy study
- prospective
- single-centre
- consecutive patients
Authors' conclusion
A multiparametric CMR protocol allows detection of ongoing myocardial inflammation and discrimination of chronic myocarditis from healed myocarditis, with segmental T2 mapping and biventricular strain analysis showing higher diagnostic accuracy compared with T1 mapping, extracellular volume fraction, and LGE.
Study context
- Population
- Patients with persistent symptoms (>30 days) suggestive of myocarditis; biopsy-proven chronic lymphocytic myocarditis (53) or healed myocarditis (50)of 452 consecutive patients
- Participants
- 103 patients
- Comparison
- Multiparametric cardiac magnetic resonance (CMR) parameters vs endomyocardial biopsy
- Outcome
- Detection of ongoing inflammation and discrimination of chronic from healed myocarditis (endomyocardial biopsy reference)
Performance
As reported in the abstract
Discrimination of chronic from healed myocarditis
| Test or model | Accuracy (≥3 segments) | AUC |
|---|---|---|
| T2 mapping | 92%; 95% CI: 85-97 | 0.87 [95% CI: 0.79-0.93]; P < 0.001 |
| LV radial peak systolic strain rate | 0.86 | |
| RV radial peak systolic strain rate | 0.84 | |
| T1 mapping | 0.64 | |
| Extracellular volume fraction | 0.62 | |
| Late gadolinium enhancement (LGE) | 0.57 |
Further findings
T2 mapping combined with troponin or C-reactive protein
- Specificity increased when T2 mapping was combined with elevation of either troponin or C-reactive protein
Original publication
Multiparametric Cardiac Magnetic Resonance Imaging to Discriminate Endomyocardial Biopsy-Proven Chronic Myocarditis From Healed Myocarditis. JACC Cardiovasc Imaging. Published 7 August 2024. doi:10.1016/j.jcmg.2024.06.009
Summarised from the published abstract; every number is checked against it