PMID- 29158437
OWN - NLM
STAT- MEDLINE
DCOM- 20171204
LR  - 20201216
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Linking)
VI  - 10
IP  - 11
DP  - 2017 Nov
TI  - Cardiac Magnetic Resonance Imaging in Myocarditis Reveals Persistent Disease 
      Activity Despite Normalization of Cardiac Enzymes and Inflammatory Parameters at 
      3-Month Follow-Up.
LID - e004262 [pii]
LID - 10.1161/CIRCHEARTFAILURE.117.004262 [doi]
AB  - BACKGROUND: There is a major unmet need to identify high-risk patients in 
      myocarditis. Although decreasing cardiac and inflammatory markers are commonly 
      interpreted as resolving myocarditis, this assumption has not been confirmed as 
      of today. We sought to evaluate whether routine laboratory parameters at 
      diagnosis predict dynamic of late gadolinium enhancement (LGE) as persistent LGE 
      has been shown to be a risk marker in myocarditis. METHODS AND RESULTS: 
      Myocarditis was diagnosed based on clinical presentation, high-sensitivity 
      troponin T, and cardiac magnetic resonance imaging, after exclusion of 
      obstructive coronary artery disease by angiography. Cardiac magnetic resonance 
      imaging was repeated at 3 months. LGE extent was analyzed with the software GT 
      Volume. Change in LGE >20% was considered significant. Investigated cardiac and 
      inflammatory markers included high-sensitivity troponin T, creatine kinase, 
      myoglobin, N-terminal B-type natriuretic peptide, C-reactive protein, and 
      leukocyte count. Twenty-four patients were enrolled. Absolute levels of cardiac 
      enzymes and inflammatory markers at baseline did not predict change in LGE at 3 
      months. Cardiac and inflammatory markers had normalized in 21 patients (88%). LGE 
      significantly improved in 16 patients (67%); however, it persisted to a lesser 
      degree in 17 of them (71%) and increased in a small percentage (21%) despite 
      normalization of cardiac enzymes. CONCLUSIONS: This is the first study reporting 
      that cardiac enzymes and inflammatory parameters do not sufficiently reflect LGE 
      in myocarditis. Although a majority of patients with normalizing laboratory 
      markers experienced improved LGE, in a small percentage LGE worsened. These data 
      suggest that cardiac magnetic resonance imaging might add value to currently 
      existing diagnostic tools for risk assessment in myocarditis.
CI  - (c) 2017 American Heart Association, Inc.
FAU - Berg, Jan
AU  - Berg J
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Kottwitz, Jan
AU  - Kottwitz J
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Baltensperger, Nora
AU  - Baltensperger N
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Kissel, Christine K
AU  - Kissel CK
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Lovrinovic, Marina
AU  - Lovrinovic M
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Mehra, Tarun
AU  - Mehra T
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Scherff, Frank
AU  - Scherff F
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Schmied, Christian
AU  - Schmied C
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Templin, Christian
AU  - Templin C
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Luscher, Thomas F
AU  - Luscher TF
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
FAU - Heidecker, Bettina
AU  - Heidecker B
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland. 
      bettina.heidecker@usz.ch.
FAU - Manka, Robert
AU  - Manka R
AD  - From the Division of Cardiology, University Hospital of Zurich, Switzerland.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - 0 (Biomarkers)
RN  - 0 (Contrast Media)
RN  - 0 (Enzymes)
RN  - 0 (Inflammation Mediators)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - Circ Heart Fail. 2017 Nov;10(11):. PMID: 29158438
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers/blood
MH  - *Clinical Enzyme Tests
MH  - Contrast Media/administration & dosage
MH  - Enzymes/*blood
MH  - Female
MH  - Gadolinium/administration & dosage
MH  - Humans
MH  - Inflammation Mediators/*blood
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocarditis/blood/*diagnostic imaging/immunology/therapy
MH  - Myocardium/*enzymology/*immunology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - biomarkers
OT  - creatine kinase
OT  - magnetic resonance imaging
OT  - myocarditis
OT  - myoglobin
OT  - natriuretic peptide, brain
OT  - troponin
EDAT- 2017/11/22 06:00
MHDA- 2017/12/05 06:00
CRDT- 2017/11/22 06:00
PHST- 2017/05/30 00:00 [received]
PHST- 2017/10/13 00:00 [accepted]
PHST- 2017/11/22 06:00 [entrez]
PHST- 2017/11/22 06:00 [pubmed]
PHST- 2017/12/05 06:00 [medline]
AID - CIRCHEARTFAILURE.117.004262 [pii]
AID - 10.1161/CIRCHEARTFAILURE.117.004262 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2017 Nov;10(11):e004262. doi: 
      10.1161/CIRCHEARTFAILURE.117.004262.