Left ventricular endocardial longitudinal dysfunction persists after acute myocarditis with preserved ejection...

Area of Science:

• Cardiology
• Medical Imaging
• Myocardial Function

Background:

• Acute myocarditis (AM) can affect left ventricular (LV) function.
• Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) detects myocardial damage in AM.
• Assessing LV myocardial deformation in AM with preserved ejection fraction is crucial.

Purpose of the Study:

• To evaluate LV myocardial deformation in patients with acute myocarditis (AM) and preserved ejection fraction.
• To assess changes in myocardial deformation over time using echocardiography.
• To correlate findings with LGE-MRI in AM patients.

Main Methods:

• Prospective enrollment of 35 male AM patients with preserved systolic function (cardiac MRI).
• Echocardiography for global and segmental longitudinal strain (LS) at endocardial (ENDO) and epicardial (EPI) levels on admission.
• Comparison with 25 control subjects and 22-month follow-up (FU) for 26 patients.

Main Results:

• On admission, global ENDO-LS was significantly reduced in AM patients (-19.2 ± 3.1) compared to controls (-24.0 ± 1.05; P < 0.0001).
• EPI-LS showed no significant difference on admission (-20.6 ± 3.4 vs -19.7 ± 6; P = NS).
• During FU, both ENDO-LS and EPI-LS showed functional improvement in magnitude in the FU group compared to admission values.

Conclusions:

• Persistent endocardial longitudinal strain impairment is demonstrated in infarct-like AM.
• This impairment occurs over a 2-year follow-up period.
• LV myocardial deformation abnormalities persist despite preserved LV ejection fraction in AM.