Speckle tracking imaging in inflammatory heart diseases

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Accurate diagnosis of acute myocarditis is crucial for patient prognosis and risk stratification.
• Cardiac magnetic resonance (CMR) is a primary diagnostic tool for myocarditis but lacks widespread availability.
• Echocardiography, particularly speckle tracking imaging, offers a potential alternative for assessing myocardial function.

Purpose of the Study:

• To evaluate regional and global longitudinal strain using speckle tracking echocardiography in patients with acute inflammatory myocardial diseases.
• To correlate speckle tracking echocardiography findings with cardiac magnetic resonance (CMR) imaging results.
• To assess the diagnostic utility of speckle tracking imaging for acute myocarditis when CMR is not accessible.

Main Methods:

• Prospective recruitment of patients with suspected acute myocarditis.
• Clinical diagnosis based on clinical, ECG, laboratory, and conventional echocardiographic data.
• All patients underwent both CMR and speckle tracking echocardiography within 24 hours of CMR, with offline analysis of echocardiographic data.

Main Results:

• Thirty-two patients with acute perimyocarditis and myopericarditis were included (mean age 29±8 years, 30 males).
• Speckle tracking echocardiography-derived ejection fraction (EF) correlated with CMR-calculated EF.
• Regional strain showed a positive correlation with delayed enhancement on CMR (r=0.52), with 85% sensitivity and 73% specificity for predicting delayed enhancement.

Conclusions:

• Speckle tracking imaging is a valuable tool for diagnosing acute myocarditis, especially when CMR is unavailable.
• Speckle tracking imaging-based EF correlates with CMR-calculated left ventricular ejection fraction (LVEF) and global strain.
• This technique aids in risk stratification and diagnosis of acute inflammatory myocardial diseases.