PMID- 31930765
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1522-2586 (Electronic)
IS  - 1053-1807 (Linking)
VI  - 52
IP  - 2
DP  - 2020 Aug
TI  - Children With Acute Myocarditis Often Have Persistent Subclinical Changes as 
      Revealed by Cardiac Magnetic Resonance.
PG  - 488-496
LID - 10.1002/jmri.27036 [doi]
AB  - BACKGROUND: Many children presenting with myocarditis may not fully recover and 
      have long-term complications, including dilated cardiomyopathy. Magnetic 
      resonance imaging (MRI) has a potential for early detection of persistent changes 
      with long-term implications, but is not performed routinely in the monitoring of 
      myocarditis. PURPOSE: To monitor adolescents who present with acute myocarditis 
      using MRI and routine diagnostic tests over the short- to mid-term. STUDY TYPE: 
      Prospective. POPULATION: Eighteen consecutive adolescents (median age 15.5, 
      interquartile range 14.8-16.9 years, 78% male) with acute myocarditis. FIELD 
      STRENGTH: A 3T scanner including cine steady-state free precession (SSFP), 
      dark-blood T(2) -weighted (T(2) W) images, and late gadolinium enhancement (LGE). 
      ASSESSMENT: The diagnosis of acute myocarditis was based on clinical symptoms and 
      signs and MRI criteria (cine, T(2) -W images, LGE). Follow-up MRI was performed 
      after median 7 months (range 6-9 months). Other routine diagnostic tests included 
      electrocardiogram (ECG), high-sensitivity troponin levels, transthoracic 
      echocardiography, and Holter monitoring. STATISTICAL TESTS: Fisher's exact test, 
      Wilcoxon test for paired samples, Mann-Whitney test for independent samples, 
      Kruskal-Wallis test. RESULTS: At baseline, 17 patients (94%) had elevated 
      troponin levels and/or ST-T changes on resting ECG; ECG showed depressed left 
      ventricular ejection fraction (LVEF<50%) in four patients (22%). At follow-up 
      there was a complete recovery in 16 patients (89%) observed with routinely 
      performed tests, with two cases of persistent ventricular arrhythmia. Despite 
      normal left ventricular volume and LVEF, MRI disclosed ongoing active 
      inflammation in five patients (28%), healed myocarditis with persistent scars in 
      eight patients (44%), and complete resolution of initially observed changes in 
      five patients (28%). DATA CONCLUSION: In children with acute myocarditis, despite 
      normalization of other routinely assessed parameters (including LVEF), there is a 
      high prevalence of persistent MRI changes showing ongoing disease or remnant 
      scars at follow-up. MRI may allow early detection and prevention of long-term 
      complications of myocarditis in the follow-up care of children with acute 
      myocarditis. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 3 J. Magn. Reson. 
      Imaging 2020. J. Magn. Reson. Imaging 2020;52:488-496.
CI  - (c) 2020 International Society for Magnetic Resonance in Medicine.
FAU - Malek, Lukasz A
AU  - Malek LA
AUID- ORCID: 0000-0002-9586-0163
AD  - Department of Epidemiology, Cardiovascular Disease Prevention and Health 
      Promotion, National Institute of Cardiology, Warsaw, Poland.
FAU - Kaminska, Halszka
AU  - Kaminska H
AD  - Department of Pediatric Cardiology and General Pediatrics, Medical University of 
      Warsaw, Warsaw, Poland.
FAU - Barczuk-Falecka, Marzena
AU  - Barczuk-Falecka M
AUID- ORCID: 0000-0003-3772-7302
AD  - Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
FAU - Ferreira, Vanessa M
AU  - Ferreira VM
AUID- ORCID: 0000-0002-0046-7634
AD  - Oxford Centre for Clinical Magnetic Resonance Research, Division of 
      Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, 
      Oxford, UK.
FAU - Wojcicka, Jolanta
AU  - Wojcicka J
AD  - Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
FAU - Brzewski, Michal
AU  - Brzewski M
AUID- ORCID: 0000-0003-3453-1013
AD  - Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
FAU - Werner, Bozena
AU  - Werner B
AUID- ORCID: 0000-0002-6416-4106
AD  - Department of Pediatric Cardiology and General Pediatrics, Medical University of 
      Warsaw, Warsaw, Poland.
LA  - eng
GR  - British Heart Foundation (BHF)/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200113
PL  - United States
TA  - J Magn Reson Imaging
JT  - Journal of magnetic resonance imaging : JMRI
JID - 9105850
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - J Magn Reson Imaging. 2020 Aug;52(2):497-498. PMID: 32406139
MH  - Acute Disease
MH  - Adolescent
MH  - Child
MH  - Contrast Media
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine
MH  - Magnetic Resonance Spectroscopy
MH  - Male
MH  - *Myocarditis/diagnostic imaging
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - children
OT  - follow-up study
OT  - magnetic resonance
OT  - myocarditis
EDAT- 2020/01/14 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/01/14 06:00
PHST- 2019/10/22 00:00 [received]
PHST- 2019/12/08 00:00 [revised]
PHST- 2019/12/10 00:00 [accepted]
PHST- 2020/01/14 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/01/14 06:00 [entrez]
AID - 10.1002/jmri.27036 [doi]
PST - ppublish
SO  - J Magn Reson Imaging. 2020 Aug;52(2):488-496. doi: 10.1002/jmri.27036. Epub 2020 
      Jan 13.