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Myocardial inflammation on cardiovascular magnetic resonance predicts left ventricular function recovery in children

Francesca Raimondi1, Franck Iserin1, Olivier Raisky1

  • 1Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.

European Heart Journal. Cardiovascular Imaging
|February 26, 2015
PubMed

Insights

Myocardial inflammation detected by cardiac magnetic resonance (CMR) in children with dilated cardiomyopathy predicts left ventricular (LV) function recovery. This finding highlights CMR

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Imaging
  • Inflammatory Heart Disease

Background:

  • Dilated cardiomyopathy (DCM) in children can lead to significant morbidity.
  • Assessing myocardial inflammation is crucial for predicting outcomes in pediatric DCM.
  • Cardiac magnetic resonance (CMR) offers advanced imaging capabilities for evaluating heart conditions.

Purpose of the Study:

  • To investigate the predictive value of myocardial inflammation, identified via CMR, for the recovery of left ventricular (LV) function in children recently diagnosed with DCM.
  • To determine if CMR findings correlate with clinical outcomes and recovery of LV function.

Main Methods:

  • A cohort of 66 children with newly diagnosed DCM underwent CMR within two weeks of diagnosis.
  • CMR utilized sequences sensitive to edema, hyperemia, and irreversible injury, including T2-weighted and late gadolinium-enhanced (LGE) imaging.
  • Myocardial inflammation was defined by the presence of at least two CMR criteria; patients were categorized as CMR-positive or CMR-negative.

Main Results:

  • 31 out of 66 children were classified as CMR-positive for myocardial inflammation.
  • Left ventricular (LV) function recovery was significantly more frequent in the CMR-positive group (24/31) compared to the CMR-negative group (11/33).
  • Myocardial inflammation (OR 3.76) and elevated troponin levels (OR 2.76) were significant predictors of LV function recovery.

Conclusions:

  • Myocardial inflammation identified by CMR at the time of diagnosis is a strong predictor of LV functional recovery in pediatric dilated cardiomyopathy.
  • CMR assessment of inflammation can aid in risk stratification and management decisions for children with DCM.
  • The absence of LGE in CMR-negative patients suggests a favorable prognosis regarding irreversible myocardial injury.
Abstract

Keywords:
cardiac magnetic resonance imagingchildrenheart failureinflammatory cardiomyopathymyocarditis

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