PMID- 32682718
OWN - NLM
STAT- MEDLINE
DCOM- 20210812
LR  - 20210812
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 13
IP  - 9
DP  - 2020 Sep
TI  - Feature Tracking Myocardial Strain Incrementally Improves Prognostication in 
      Myocarditis Beyond Traditional CMR Imaging Features.
PG  - 1891-1901
LID - S1936-878X(20)30421-6 [pii]
LID - 10.1016/j.jcmg.2020.04.025 [doi]
AB  - OBJECTIVES: This study investigated the association of cardiovascular cardiac 
      magnetic resonance (CMR) feature tracking (FT) with outcome in a patient cohort 
      with myocarditis and evaluated the possible incremental prognostic benefit beyond 
      clinical features and traditional CMR features. BACKGROUND: CMR is used to 
      diagnose and risk stratify patients with myocarditis. CMR-FT allows quantitative 
      strain analysis of myocardial function; however, its prognostic benefit in 
      myocarditis is unknown. METHODS: Consecutive patients with clinically suspected 
      myocarditis and presence of midmyocardial or epicardial late gadolinium 
      enhancement (LGE) and/or myocardial edema in CMR were included. Clinical and CMR 
      features were analyzed with regard to major adverse cardiovascular events (MACE) 
      (i.e., hospitalization for heart failure, sustained ventricular tachycardia, and 
      all-cause mortality). RESULTS: Of 740 patients with clinically suspected 
      myocarditis, 455 (61%) met our final diagnostic criteria based on CMR tissue 
      characterization. At a median follow-up of 3.9 years, MACE occurred in 74 (16%) 
      patients. In the univariable analysis, CMR-FT global longitudinal peak strain 
      (GLS) was significantly associated with MACE. In a multivariable model adjusting 
      for clinical variables (age, sex, body mass index, and acuteness of symptoms) and 
      traditional CMR features (left ventricular ejection fraction [LVEF] and LGE 
      extent), GLS remained independently associated with outcome (GLS hazard ratio: 
      1.21; 95% confidence interval: 1.08 to 1.36; p = 0.001) and incrementally 
      improved prognostication (chi-square increases from 42.6 to 79.8 to 88.5; 
      p < 0.001). CONCLUSIONS: Myocardial strain using CMR-FT provides independent and 
      incremental prognostic value over clinical features, LVEF, and LGE in patients 
      with myocarditis. CMR-FT may serve as a novel marker to improve risk 
      stratification in myocarditis. (CMR Features in Patients With Suspected 
      Myocarditis [CMRMyo]; NCT03470571).
CI  - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Fischer, Kady
AU  - Fischer K
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland; Department of Anaesthesiology and Pain Medicine, 
      Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
FAU - Obrist, Sarah J
AU  - Obrist SJ
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Erne, Sophie A
AU  - Erne SA
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Stark, Anselm W
AU  - Stark AW
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Marggraf, Maximilian
AU  - Marggraf M
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Kaneko, Kyoichi
AU  - Kaneko K
AD  - Non-invasive Cardiovascular Imaging, Cardiovascular Division, Department of 
      Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, 
      Massachusetts.
FAU - Guensch, Dominik P
AU  - Guensch DP
AD  - Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University 
      Hospital, University of Bern, Bern, Switzerland; Department of Diagnostic, 
      Interventional and Paediatric Radiology, Inselspital, Bern University Hospital, 
      University of Bern, Bern, Switzerland.
FAU - Huber, Adrian T
AU  - Huber AT
AD  - Department of Diagnostic, Interventional and Paediatric Radiology, Inselspital, 
      Bern University Hospital, University of Bern, Bern, Switzerland.
FAU - Greulich, Simon
AU  - Greulich S
AD  - Department of Cardiology and Angiology, University of Tubingen, Tubingen, 
      Germany.
FAU - Aghayev, Ayaz
AU  - Aghayev A
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Steigner, Michael
AU  - Steigner M
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts.
FAU - Blankstein, Ron
AU  - Blankstein R
AD  - Non-invasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts.
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, Boston, 
      Massachusetts.
FAU - Grani, Christoph
AU  - Grani C
AD  - Department of Cardiology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland; Non-invasive Cardiovascular Imaging, Cardiovascular 
      Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical 
      School, Boston, Massachusetts. Electronic address: christoph.graeni@insel.ch.
LA  - eng
SI  - ClinicalTrials.gov/NCT03470571
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200715
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2020 Sep;13(9):1902-1905. PMID: 32739377
MH  - Contrast Media
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine
MH  - *Myocarditis
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Factors
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - cardiovascular magnetic resonance
OT  - feature tracking
OT  - late gadolinium enhancement
OT  - major adverse cardiac event
OT  - myocarditis
OT  - strain
EDAT- 2020/07/20 06:00
MHDA- 2021/08/13 06:00
CRDT- 2020/07/20 06:00
PHST- 2020/02/07 00:00 [received]
PHST- 2020/04/20 00:00 [revised]
PHST- 2020/04/21 00:00 [accepted]
PHST- 2020/07/20 06:00 [pubmed]
PHST- 2021/08/13 06:00 [medline]
PHST- 2020/07/20 06:00 [entrez]
AID - S1936-878X(20)30421-6 [pii]
AID - 10.1016/j.jcmg.2020.04.025 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2020 Sep;13(9):1891-1901. doi: 
      10.1016/j.jcmg.2020.04.025. Epub 2020 Jul 15.