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Clinical and magnetic resonance evolution of “infarct-like” myocarditis

  • Cardiac radiology
  • Published:
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Abstract

Aims

To analyse the clinical and magnetic resonance evolution of myocarditis in patients with an “infarct-like” presentation pattern.

Methods

The study is a retrospective analysis of 52 patients with clinical diagnosis of “infarct-like” myocarditis confirmed by CMR as acute myocarditis according to Lake Louise criteria and 6 months follow-up. The CMR protocol included T2-weighted (oedema), early (hyperaemia) and late (fibrosis/necrosis) gadolinium enhancement sequences, according to Lake Louise criteria. Clinical and radiological follow-up by CMR was performed after a median time interval of 6 months (interquartile range 5–8). Quantitative outcomes were checked for normality and compared with the non-parametric Wilcoxon’s test for matched data.

Results

At the clinical follow-up all patients were free of symptoms and reported no cardiac complications. The CMR follow-up evidenced a significant increase of the ejection fraction (from 53 ± 6 to 55 ± 4%, p = 0.03), a decrease of the ventricular mass [from 67.0 (58.8–79.0) to 61.0 (54.0–67.0), p < 0.0001] without significant modification of the cardiac volume index (p = 0.26). No patient had residual oedema or capillary leakage: the T2 ratio decreased from 3.94 (3.00–4.86) to 0.98 (0.75–1.17) with p < 0.0001 and the Early gadolinium enhancement (EGE) ratio from 5.7 (4.8–6.5) to 2.9 (2.4–3.2) with p < 0.0001. Late gadolinium enhancement (LGE) persisted over the course of the follow-up in 48/52 patients, but with a significant reduction in every patient (LGE % from 34.3 ± 9.1 to 19.4 ± 6.6%; p < 0.0001).

Conclusion

Patients diagnosed with “infarct-like” myocarditis, according to both clinical and CMR examinations may look forward to a positive evolution with a good prognosis.

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Authors and Affiliations

  1. Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy

    Riccardo Faletti, Marco Gatti, Ilaria Baralis, Silvia Stola & Paolo Fonio

  2. Department of Surgical Sciences, University of Turin, Turin, Italy

    Laura Bergamasco & Rodolfo Bonamini

  3. Division of Pediatric Cardiology, Citta’ della Salute e della Scienza, Turin, Italy

    Francesca Ferroni

  4. University Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Torino, Turin, Italy

    Massimo Imazio & Fiorenzo Gaita

Authors
  1. Riccardo Faletti
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  2. Marco Gatti
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  3. Ilaria Baralis
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  4. Laura Bergamasco
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Correspondence to Marco Gatti.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Faletti, R., Gatti, M., Baralis, I. et al. Clinical and magnetic resonance evolution of “infarct-like” myocarditis. Radiol med 122, 273–279 (2017). https://doi.org/10.1007/s11547-016-0723-5

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  • DOI: https://doi.org/10.1007/s11547-016-0723-5

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