PMID- 24933194 OWN - NLM STAT- MEDLINE DCOM- 20160525 LR - 20150831 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 16 IP - 10 DP - 2015 Oct TI - Myocardial biomarkers and delayed enhanced cardiac magnetic resonance relationship in clinically suspected myocarditis and insight on clinical outcome. PG - 696-703 LID - 10.2459/JCM.0000000000000024 [doi] AB - AIMS: The relationship of cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) with myocardial biomarkers and markers of inflammation in acute viral myocarditis is not clearly defined. We assessed the relationship of LGE with myocardial and inflammatory biomarkers measured during the acute phase of myocarditis and their predictive value on clinical outcome. METHODS: Patients with first clinical episode of acute viral myocarditis and complete CMR study, including cine and LGE images, were included. The peak values of troponin I, creatine kinase, C-reactive protein value at admission and LGE extent were reported for each case. A 29-month clinical follow-up was performed, and cardiac symptoms and adverse cardiac events (all-cause death, heart transplant, hospitalization for heart failure) were reported. RESULTS: Forty-one patients (39 +/- 15 years and 78% men) were included. Median LGE extent was 13% [interquartile range (IQR) (9%, 19%)] of left-ventricular mass and mean left-ventricular ejection fraction was 56 +/- 11%. There was a significant correlation between peak troponin I and LGE extent (r = 0.51, P < 0.001), and between peak creatine kinase and LGE extent (r = 0.66, P < 0.001). There was no correlation between C-reactive protein at admission and LGE extent (r = 0.27, P = 0.09). At follow-up, eight (20%) patients had an adverse clinical event. LGE extent was significantly associated with a worse New York Heart Association status at follow-up [odds ratio (OR) 1.21, 95% confidence interval (CI) 1.07, 1.37, P = 0.002]. After adjustment for left-ventricular ejection fraction, age and clinical presentation category, LGE extent remained an independent predictor of cardiovascular events (hazard ratio 1.42; 95% CI 1.05, 1.95, P = 0.027). CONCLUSIONS: LGE extent on CMR studies is significantly correlated to biomarkers of myocardial injury in patients with acute viral myocarditis, and is a significant independent predictor of adverse cardiovascular outcome. FAU - Mewton, Nathan AU - Mewton N AD - aHopital Cardiovasculaire Louis Pradel, Department of Intensive and Coronary Care, Hospices Civils de Lyon, Bron bDepartment of Biostatistics, Hospices Civils de Lyon, Universite Claude Bernard Lyon, Lyon cHopital Cardiovasculaire Louis Pradel, Centre d'Investigation CliniqueUnite INSERM 1407 dHopital Cardiovasculaire Louis Pradel, Department of Radiology, Hospices Civils de Lyon, Bron, France. FAU - Dernis, Adeline AU - Dernis A FAU - Bresson, Didier AU - Bresson D FAU - Zouaghi, Oualid AU - Zouaghi O FAU - Croisille, Pierre AU - Croisille P FAU - Flocard, Elodie AU - Flocard E FAU - Douek, Philippe AU - Douek P FAU - Bonnefoy-Cudraz, Eric AU - Bonnefoy-Cudraz E LA - eng PT - Journal Article PT - Observational Study PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Troponin I) RN - 9007-41-4 (C-Reactive Protein) RN - AU0V1LM3JT (Gadolinium) RN - EC 2.7.3.2 (Creatine Kinase) SB - IM MH - Adult MH - Biomarkers MH - C-Reactive Protein/*analysis MH - Contrast Media MH - Creatine Kinase/*blood MH - Female MH - Follow-Up Studies MH - Gadolinium/*analysis MH - Humans MH - Magnetic Resonance Imaging, Cine/*adverse effects MH - Male MH - Middle Aged MH - Myocarditis/*complications MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Factors MH - Tertiary Care Centers MH - Troponin I/*blood MH - Ventricular Function, Left MH - Young Adult EDAT- 2014/06/17 06:00 MHDA- 2016/05/26 06:00 CRDT- 2014/06/17 06:00 PHST- 2014/06/17 06:00 [entrez] PHST- 2014/06/17 06:00 [pubmed] PHST- 2016/05/26 06:00 [medline] AID - 10.2459/JCM.0000000000000024 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2015 Oct;16(10):696-703. doi: 10.2459/JCM.0000000000000024.