TY - JOUR
T1 - Role of right ventricular involvement in acute myocarditis, assessed by cardiac magnetic resonance
AU - Aquaro, Giovanni Donato
AU - Negri, Francesco
AU - De Luca, Antonio
AU - Todiere, Giancarlo
AU - Bianco, Francesco
AU - Barison, Andrea
AU - Camastra, Giovanni
AU - Monti, Lorenzo
AU - Dellegrottaglie, Santo
AU - Moro, Claudio
AU - Lanzillo, Chiara
AU - Scatteia, Alessandra
AU - Di Roma, Mauro
AU - Pontone, Gianluca
AU - Perazzolo Marra, Martina
AU - Di Bella, Gianluca
AU - Donato, Rocco
AU - Grigoratos, Chrysanthos
AU - Emdin, Michele
AU - Sinagra, Gianfranco
PY - 2018/11/15
Y1 - 2018/11/15
N2 - Objectives: Right ventricular (RV) myocarditis (MY) is unrecognized, and its prevalence is unknown. We evaluated the prevalence of RV involvement in acute MY and its association with cardiac events (cardiac death, cardiac arrest, ventricular assist device, transplantation, and appropriate ICD intervention). Methods: We enrolled 151 patients who underwent cardiac magnetic resonance for clinical suspicion of acute MY. The CMR protocol included T2-STIR images for edema detection, post-contrast cine-SSFP for hyperemia detection and late gadolinium enhancement (LGE) images. Results: Signs of RV MY were found in 27 patients (17.8%): RV edema at T2-STIR in all of these 27 patients; RV LGE was detected in 11 patients (7.3%). The median RV myocardial segment involved was 2 (1–3). In 13 patients, RV edema was in direct continuity with LV edema of septum and inferior wall or with anterior septum and anterior wall. In 2 patients RV myocarditis was found without any signs of LV involvement. Patients with RV MY had higher RV end-diastolic volume index (p = 0.04) and RV mass index (p = 0.03), and lower RV ejection fraction (p < 0.001) than others. At Kaplan-Meier survival curve patients with RV MY had more cardiac events than those without RV involvement (p = 0.015). RV involvement, anteroseptal LGE and RV LGE were associated with cardiac events. Conclusion: RV involvement in acute MY is more frequent than previously hypothesized. RV MY was associated with cardiac events.
AB - Objectives: Right ventricular (RV) myocarditis (MY) is unrecognized, and its prevalence is unknown. We evaluated the prevalence of RV involvement in acute MY and its association with cardiac events (cardiac death, cardiac arrest, ventricular assist device, transplantation, and appropriate ICD intervention). Methods: We enrolled 151 patients who underwent cardiac magnetic resonance for clinical suspicion of acute MY. The CMR protocol included T2-STIR images for edema detection, post-contrast cine-SSFP for hyperemia detection and late gadolinium enhancement (LGE) images. Results: Signs of RV MY were found in 27 patients (17.8%): RV edema at T2-STIR in all of these 27 patients; RV LGE was detected in 11 patients (7.3%). The median RV myocardial segment involved was 2 (1–3). In 13 patients, RV edema was in direct continuity with LV edema of septum and inferior wall or with anterior septum and anterior wall. In 2 patients RV myocarditis was found without any signs of LV involvement. Patients with RV MY had higher RV end-diastolic volume index (p = 0.04) and RV mass index (p = 0.03), and lower RV ejection fraction (p < 0.001) than others. At Kaplan-Meier survival curve patients with RV MY had more cardiac events than those without RV involvement (p = 0.015). RV involvement, anteroseptal LGE and RV LGE were associated with cardiac events. Conclusion: RV involvement in acute MY is more frequent than previously hypothesized. RV MY was associated with cardiac events.
KW - Acute myocarditis
KW - Cardiac magnetic resonance
KW - Late gadolinium enhancement
KW - Myocardial edema
KW - Prognosis
KW - Right ventricular myocarditis
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U2 - 10.1016/j.ijcard.2018.04.087
DO - 10.1016/j.ijcard.2018.04.087
M3 - Article
C2 - 30045820
AN - SCOPUS:85046357949
VL - 271
SP - 359
EP - 365
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -