Abstract 1927: Role of Cardiac Magnetic Resonance Imaging in Patients with Myocarditis: Does late Enhancement have Prognostic Value?
Background: The aim of our study is to analyse changes in MRI findings 6 months after the acute phase and to evaluate its prognostic value.
Methods: We analysed 26 consecutive patients diagnosed of myocarditis in our institutions. MR examinations were performed with a 1.5-T unit (Intera 9.0; Philips®), including cine image acquisition and delayed enhancement (DE) imaging. A total dose of 0.2 mmol/kg of Gd-DTPA was administered.and DE-enhancement image acquisition was performed 10 minutes later in short and long axis views (3D-T1-TFE sequence with a specific inversion prepulse). Patients underwent clinical follow-up and MR examinations 6 months later.
Results: Mean age was 34 ± 15 years old and 23 patients (89%) were male. 18 patients (69%) showed segmental contractile dysfunction in the acute phase; mean ejection fraction was 52 ± 6 %. Areas of DE were detected in all patients; all patients but 3 showed multifocal pattern. Myocardial involvement was most frequent in the lateral wall (68%), followed by the inferior wall (32%). 6 months’ follow-up was completed in 17 patients (65%). Mean change in ejection fraction 6 months later was 10 ± 9%. Significant reduction of extension of DE foci was observed in 10 cases (58%) but only in one case they completely disappeared . However, patients with LE reduction did not show higher LV function recovery (8% vs 7%, p = 0.9). No adverse events were reported at follow-up.
Conclusions: Persistence of contrast enhancement in CMR during follow-up is a frequent finding in myocarditis. However, it does not seem related to mid-term clinical evolution nor to absence of left ventricular function recovery.