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The Relationship Between Electrocardiographic Findings and Cardiac Magnetic Resonance Results in Patients with Acute

Michaela Kyriakou1, Nikolaos P E Kadoglou2, Stefanos Sokratous1

  • 1Department of Cardiology, Nicosia General Hospital, 2029 Nicosia, Cyprus.

Medicina (Kaunas, Lithuania)
|August 28, 2025
PubMed

Insights

Electrocardiography (ECG) abnormalities, especially ST elevation and T-wave changes, are common in acute myocarditis. These ECG findings correlate significantly with cardiac magnetic resonance (CMR) imaging results, suggesting ECG

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Tools

Background:

  • Electrocardiography (ECG) is a widely used, though non-specific, tool for diagnosing acute myocarditis.
  • Cardiac magnetic resonance (CMR) has emerged as a crucial non-invasive diagnostic method.
  • Assessing the relationship between ECG findings, echocardiography, biomarkers, and CMR features is vital for acute myocarditis diagnosis.

Purpose of the Study:

  • To evaluate the association between baseline ECG findings and CMR imaging features (myocardial edema and late gadolinium enhancement-LGE) in acute myocarditis patients.
  • To determine the correlation of ECG abnormalities with echocardiographic parameters and circulating biomarkers.
  • To explore the role of ECG as an initial screening tool in acute myocarditis.

Main Methods:

  • A retrospective observational study of 86 acute myocarditis patients.
  • Data collection included ECG, echocardiography, troponin I, CRP, and CMR imaging (edema and LGE).
  • Patients were stratified into three ECG groups: no ST elevation or T-wave abnormalities (NSTG), T-wave abnormalities (TWAG), and ST elevation (STEG).

Main Results:

  • The prevalence of myocardial edema and LGE on CMR was significantly higher in the ST elevation group (STEG) compared to other ECG groups (p < 0.05).
  • Peak troponin levels were elevated in the STEG.
  • T-wave abnormalities (TWAs) were independently associated with both myocardial edema (OR=3.15) and LGE (OR=3.93) on CMR.

Conclusions:

  • ECG abnormalities, particularly ST elevation and T-wave abnormalities, are prevalent in acute myocarditis and show significant associations with CMR findings.
  • CMR remains essential for definitive diagnosis and risk stratification.
  • ECG can serve as a valuable initial screening tool within a multimodal diagnostic strategy for acute myocarditis.

Keywords:
CMRLGEST elevationT-wave abnormalitiesacute myocarditismyocardial edema

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