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Atrial and Ventricular Involvement in Acute Myocarditis Patients with Preserved Ejection Fraction: A Single-Center

Riccardo Cau1, Francesco Pisu1, Giuseppe Muscogiuri2,3

  • 1Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato s.s. 554 Monserrato (Cagliari), 09045 Cagliari, Italy.

Journal of Cardiovascular Development and Disease
|July 26, 2024
PubMed

Insights

Assessing atrial and ventricular strain using cardiac magnetic resonance (CMR) can improve diagnosing acute myocarditis (AM) in patients with preserved ejection fraction (EF). This combined approach enhances diagnostic accuracy for this specific patient group.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Cardiac magnetic resonance (CMR) is a key tool for diagnosing acute myocarditis (AM).
  • The role of atrial and ventricular function in AM patients with preserved ejection fraction (EF) requires further study.
  • Preserved EF in AM patients can complicate diagnosis, necessitating advanced imaging techniques.

Purpose of the Study:

  • To investigate the added diagnostic value of combining atrial and ventricular strain analysis via CMR in AM patients with preserved EF.
  • To assess the effectiveness of integrated functional assessments in differentiating AM from healthy controls in this cohort.

Main Methods:

  • Retrospective analysis of CMR scans from 126 AM patients (meeting Lake Louise criteria, preserved EF) and 52 controls.
  • Assessment of left atrial (LA) and left ventricular (LV) strain functions using standard cine-SSFP sequences.
  • Multivariable analysis to evaluate the significance of strain impairments.

Main Results:

  • Patients with AM and preserved EF exhibited significantly impaired LA and LV strain functions compared to controls.
  • These functional impairments remained statistically significant after multivariable adjustment.
  • A combined model incorporating atrial and ventricular strain functions demonstrated superior diagnostic performance (AUC 0.77) compared to individual measures.

Conclusions:

  • Impaired atrial and ventricular strain are characteristic findings in AM patients with preserved EF.
  • Combining atrial and ventricular strain analysis using CMR offers improved diagnostic accuracy for AM in this population.
  • This integrated functional assessment approach enhances the ability to distinguish AM patients with preserved EF from healthy individuals.

Keywords:
atrial strainmyocarditispreserved ejection fractionventricular strain

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