PMID- 27035605 OWN - NLM STAT- MEDLINE DCOM- 20170607 LR - 20170817 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 212 DP - 2016 Jun 1 TI - Prognostic value of the infarct- and non-infarct like patterns and cardiovascular magnetic resonance parameters on long-term outcome of patients after acute myocarditis. PG - 63-9 LID - S0167-5273(16)30415-6 [pii] LID - 10.1016/j.ijcard.2016.03.004 [doi] AB - BACKGROUND: Prognostic value of the infarct- and non-infarct like patterns and cardiac magnetic resonance (CMR) parameters on long-term outcome of patients after acute myocarditis is not well known. METHODS: Between 2006 and 2015, 112 consecutive patients with CMR-based diagnosis of acute myocarditis were identified in our institution. Of them, 88 were available for clinical follow-up and represented our studied population. Patients were divided into infarct-like group (n=48) (association of acute chest pain, elevated Troponin levels and ST-elevation) and non-infarct-like group (n=40) with any other presentation. The composite primary endpoint of major cardiovascular events (MACE) included: all-cause mortality, cardiac mortality, recurrence of myocarditis, heart failure, and sustained ventricular tachycardia. RESULTS: During follow-up, 21 patients (24%) experienced MACE and infarct-like patients were significantly more at risk for MACE than non-infarct-like patients (HR 2.4, 95% CI [1.01-5.80] p=0.04). Infarct-like patients exhibited in particular a higher risk of sustained ventricular tachycardia and recurrence of myocarditis (p=0.03). They had lower CMR-derived left (p=0.03) and right (p=0.001) ventricular ejection fractions, and exhibited larger areas of late gadolinium enhancement (LGE) (p=0.001). In multivariate analysis, both initial NYHA functional class >II and LGE mass were independent predictors for long-term MACE occurrence (HR 5.8 and 1.07 per gram respectively, p=0.007). Moreover, a threshold of LGE mass >17g provided a high discrimination for MACE occurrence (AUC of 0.81). CONCLUSIONS: The infarct-like pattern of acute myocarditis is associated with MACE occurrence. Initial NYHA functional class >II and LGE are independent predictive factors of MACE during long-term follow-up after acute myocarditis. CI - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved. FAU - Chopra, Houzefa AU - Chopra H AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France. FAU - Arangalage, Dimitri AU - Arangalage D AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France. FAU - Bouleti, Claire AU - Bouleti C AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France. FAU - Zarka, Samuel AU - Zarka S AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France. FAU - Fayard, Florence AU - Fayard F AD - Gustave Roussy, Service de Biostatistique et d'Epidemiologie, Villejuif, 94805, France; CESP Centre for Research in Epidemiology and Population Health, INSERM U1018 (Team 2, Methodology and clinical epidemiology in molecular oncology), Universite Paris-Sud, Villejuif 94805, France. FAU - Chillon, Sylvie AU - Chillon S AD - Department of Radiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France. FAU - Laissy, Jean-Pierre AU - Laissy JP AD - Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France; Department of Radiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148 Bichat Hospital, Paris, France. FAU - Henry-Feugeas, Marie-Cecile AU - Henry-Feugeas MC AD - Department of Radiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France. FAU - Steg, Philippe-Gabriel AU - Steg PG AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France; INSERM U1148 Bichat Hospital, Paris, France. FAU - Vahanian, Alec AU - Vahanian A AD - Department of Cardiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France; INSERM U1148 Bichat Hospital, Paris, France. FAU - Ou, Phalla AU - Ou P AD - Faculte de Medecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, France; Department of Radiology, Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France; INSERM U1148 Bichat Hospital, Paris, France. Electronic address: phalla.ou@aphp.fr. LA - eng PT - Journal Article PT - Observational Study DEP - 20160314 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Acute Disease MH - Adult MH - Female MH - Follow-Up Studies MH - Humans MH - Magnetic Resonance Imaging, Cine/*trends MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging/*epidemiology MH - Myocarditis/*diagnostic imaging/*epidemiology MH - Prognosis MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - Acute myocarditis OT - Cardiac magnetic resonance imaging OT - Infarct-like OT - Late gadolinium enhancement OT - Outcome EDAT- 2016/04/02 06:00 MHDA- 2017/06/08 06:00 CRDT- 2016/04/02 06:00 PHST- 2016/01/22 00:00 [received] PHST- 2016/03/12 00:00 [accepted] PHST- 2016/04/02 06:00 [entrez] PHST- 2016/04/02 06:00 [pubmed] PHST- 2017/06/08 06:00 [medline] AID - S0167-5273(16)30415-6 [pii] AID - 10.1016/j.ijcard.2016.03.004 [doi] PST - ppublish SO - Int J Cardiol. 2016 Jun 1;212:63-9. doi: 10.1016/j.ijcard.2016.03.004. Epub 2016 Mar 14.