PMID- 30756221
OWN - NLM
STAT- MEDLINE
DCOM- 20190610
LR  - 20200225
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Linking)
VI  - 35
IP  - 6
DP  - 2019 Jun
TI  - Incremental value of extracellular volume assessment by cardiovascular magnetic 
      resonance imaging in risk stratifying patients with suspected myocarditis.
PG  - 1067-1078
LID - 10.1007/s10554-019-01552-6 [doi]
AB  - Cardiovascular magnetic resonance imaging (CMR) has become a key investigative 
      tool in patients with suspected myocarditis. However, the prognostic implications 
      of T1 mapping, including extracellular volume (ECV) calculation, is less clear. 
      Patients with suspected myocarditis who underwent CMR evaluation, including T1 
      mapping at our institution were included. CMR findings including late gadolinium 
      enhancement (LGE), left ventricular ejection fraction (LVEF), native T1 mapping, 
      and ECV calculation were associated with first major adverse cardiac events 
      (MACE). MACE included a composite of all-cause death, heart failure 
      hospitalization, heart transplantation, documented sustained ventricular 
      arrhythmia, and recurrent myocarditis. One hundred seventy-nine patients with a 
      mean age of 49 +/- 15 years were identified. Seventy nine individuals (44%) were 
      female. Mean LVEF was 48 +/- 16. At a median follow-up of 4.1 [interquartile-range 
      (IQR) 2.2-6.1] years, 22 (12%) patients experienced a MACE. Mean ECV (per 10%) 
      was significantly associated with MACE (HR 2.09, 95% CI 1.07-4.08, p = 0.031). 
      Presence of ECV >/= 35% demonstrated significant univariable association with MACE 
      (HR 3.3, 95% CI 1.43-7.97, p = 0.005) and such association was maintained when 
      adjusted to LVEF (HR 3.42, 95% CI 1.42-7.94, p = 0.006). ECV >/= 35% portended a 
      greater than threefold increased hazards to MACE adjusted to LGE presence (HR 
      3.14, 95% CI 1.29-7.36, p = 0.012). In patients without LGE, ECV >/= 35% portended 
      a greater than sixfold increased hazards (HR 6.6, p = 0.010). In the 
      multivariable model including age, LVEF and LGE size, only ECV >/= 35% maintained 
      its significant association with outcome. ECV calculation by CMR is a useful tool 
      in the risk stratification of patients with clinically suspected myocarditis, 
      incremental to LGE and LVEF.
FAU - Grani, Christoph
AU  - Grani C
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis 
      Street, Boston, MA, 02115, USA.
FAU - Biere, Loic
AU  - Biere L
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis 
      Street, Boston, MA, 02115, USA.
FAU - Eichhorn, Christian
AU  - Eichhorn C
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis 
      Street, Boston, MA, 02115, USA.
FAU - Kaneko, Kyoichi
AU  - Kaneko K
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis 
      Street, Boston, MA, 02115, USA.
FAU - Agarwal, Vikram
AU  - Agarwal V
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Aghayev, Ayaz
AU  - Aghayev A
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Steigner, Michael
AU  - Steigner M
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Blankstein, Ron
AU  - Blankstein R
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Jerosch-Herold, Michael
AU  - Jerosch-Herold M
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, MA, USA.
FAU - Kwong, Raymond Y
AU  - Kwong RY
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis 
      Street, Boston, MA, 02115, USA. rykwong@partners.org.
LA  - eng
PT  - Journal Article
DEP - 20190212
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Contrast Media/administration & dosage
MH  - Disease Progression
MH  - Female
MH  - Gadolinium DTPA/administration & dosage
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Myocarditis/*diagnostic imaging/mortality/physiopathology/therapy
MH  - Predictive Value of Tests
MH  - Progression-Free Survival
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - *Stroke Volume
MH  - Time Factors
MH  - *Ventricular Function, Left
MH  - Young Adult
OTO - NOTNLM
OT  - CMR
OT  - Cardiovascular magnetic resonance imaging
OT  - Extracellular volume
OT  - Myocarditis
OT  - Outcome
OT  - T1 mapping
EDAT- 2019/02/14 06:00
MHDA- 2019/06/14 06:00
CRDT- 2019/02/14 06:00
PHST- 2018/08/20 00:00 [received]
PHST- 2019/02/02 00:00 [accepted]
PHST- 2019/02/14 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2019/02/14 06:00 [entrez]
AID - 10.1007/s10554-019-01552-6 [pii]
AID - 10.1007/s10554-019-01552-6 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2019 Jun;35(6):1067-1078. doi: 
      10.1007/s10554-019-01552-6. Epub 2019 Feb 12.