Early diastolic septal movement in patients with myocarditis. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Jeserich, M.; Merkely, B.; Schlosser, P.; Kimmel, S.; Pavlik, G.; Biermann, J.
• Is Part Of: Clinical radiology. Volume 73:Issue 2(2018)
• Page Start: 219.e9
• Page End: 219.e15
• Publication Date: 2018-02
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2017.09.008
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : Aim: To evaluate early diastolic septal relaxation as a parameter in the diagnostic workup via cardiovascular magnetic resonance imaging (CMRI) in patients with myocarditis. Materials and methods: Early diastolic septal movement was evaluated (EDS) prospectively via frame-by-frame analysis in 255 consecutive patients with presenting signs of myocarditis and in 64 controls matched 4:1 for gender and age. ECG-triggered, T2-weighted, fast spin echo triple inversion recovery sequences and late gadolinium enhancement were obtained, as well as left ventricular (LV) function and dimensions in patients and controls. Results: EDS was detected in 66.7% of the patients and 18.7% of the controls ( p< 0.001). Sensitivity was 69.4% and specificity 79.7%. Patients with EDS had a significant lower LV ejection fraction (LV-EF) of 61.1 ± 0.6% and significant higher end-diastolic volume (EDV) of 158.5 ± 2.7 ml than in patients without EDS (LV-EF 65.3 ± 0.9%, p =0.0001; EDV 148.4 ± 3.9 ml, p =0.04). A significant negative correlation was observed between LV-EF and EDS in patients, and a lower LV-EF correlated with a more frequent occurrence of EDS ( r =–0.24, p =0.0001). Scar tissue was also more frequent in patients than controls (63.1% and 7.8%, p =0.007). Conclusions: EDS is a parameter obtained non-invasively by CMRI and is present in a high percentage of patients with myocarditis. Cardiac functional parameters are significantly altered in patients with EDS. EDS is a feasible parameter that can play an important role in the diagnosis of myocarditis. Highlights: Evaluation of early diastolic septal relaxation (EDS) as a parameter in the diagnostic workup via cardiovascular magnetic resonance imaging. Detection of EDS in 66.7% of the patients and 18.7% of the controls. Sensitivity was 69.4% and specificity 79.7%. Patients with EDS had a significant lower ejection fraction and higher end-diastolic volume than patients without EDS. EDS is a parameter obtained non-invasively by CMRI and is present in a high percentage of patients with myocarditis. Cardiac functional parameters are significantly altered in patients with EDS.