Unveiling the Diagnostic Value of Strain Parameters Across All 4 Cardiac Chambers in Patients With Acute Myocarditis With Varied Ejection Fraction: A Cardiovascular Magnetic Resonance Feature-Tracking Approach

被引：1

作者：

Zhang, Xinping ^{[1
]}

Wang, Ce ^{[1
]}

Huang, Yuantao ^{[1
]}

Zhang, Shi-jun ^{[2
]}

Xu, Junqing ^{[2
,3
]}

机构：

[1] Southeast Univ, Zhongda Hosp, Sch Med, Jiangsu Key Lab Mol & Funct Imaging,Dept Radiol, Nanjing, Jiangsu, Peoples R China

[2] Guangdong Med Univ, Dept Radiol, Affiliated Hosp, 57 S Renmin Rd, Zhanjiang, Guangdong, Peoples R China

[3] Southern Univ Sci, Technol Hosp, Dept Radiol, Shenzhen, Guangdong, Peoples R China

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2024年 / 13卷 / 13期

基金：

中国国家自然科学基金;

关键词：

cardiovascular magnetic resonance; feature tracking; myocardial strain; myocarditis; LEFT ATRIAL STRAIN; VENTRICULAR SYSTOLIC FUNCTION; GLOBAL LONGITUDINAL STRAIN; CLINICAL-RELEVANCE; HEART; ASSOCIATION; DYSFUNCTION; MECHANICS; FAILURE; HEALTH;

D O I：

10.1161/JAHA.123.032781

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: This study assesses the diagnostic utility of strain parameters from cardiovascular magnetic resonance feature tracking across all cardiac chambers in patients with acute myocarditis, stratified by ejection fraction. METHODS AND RESULTS: Our cohort included 65 patients with acute myocarditis and 25 healthy controls; all underwent cardiac magnetic resonance imaging. Patients were divided into 2 groups based on left ventricular ejection fraction (EF)with a 55% cutoff: acute myocarditis with preserved EF, EF >= 55%, n=48; and acute myocarditis with reduced EF, EF <55%, n=17. The control group matched for age and sex. Cardiovascular magnetic resonance feature tracking evaluated strain parameters across all cardiac chambers. Both acute myocarditis with preserved EF and acute myocarditis with reduced EF groups showed significant decreases in left atrial peak early negative strain rate compared with controls. The acute myocarditis with reduced EF group had significantly reduced left ventricular circumferential strain relative to acute myocarditis with preserved EF and controls. Receiver operating characteristic curve analysis confirmed the diagnostic accuracy in distinguishing patients with acute myocarditis with preserved EF from controls, with left atrial peak early negative strain rate achieving 92.9% specificity, left ventricular circumferential strain demonstrating an area under the curve of 0.832, and similarly effective results for left ventricular longitudinal strain and right ventricular longitudinal strain. Additionally, left atrial peak early negative strain rate and left ventricular circumferential strain showed significant correlations with troponin I levels, indicating myocardial injury. CONCLUSIONS: Cardiovascular magnetic resonance feature-tracking-derived strain parameters, particularly left atrial peak early negative strain rate and left ventricular circumferential strain, effectively diagnose acute myocarditis across different EFs, enhancing diagnostic accuracy and facilitating early detection, notably in patients with preserved EF.

引用

页数：17