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Speckle tracking imaging in inflammatory heart diseases

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Abstract

Accurate diagnosis of acute myocarditis is important for the prognosis and risk stratification of these patients. Cardiac magnetic resonance (CMR) has become a major modality for diagnosis of myocarditis, but not widely available. In this study, we tried to evaluate regional and global longitudinal strain by speckle tracking echocardiography in patients with acute inflammatory myocardial diseases in correlation with CMR. Patients with suspected acute myocarditis were recruited prospectively. Clinical diagnosis was established based on clinical, electrocardiographic, laboratory and conventional echocardiographic data. All patients underwent CMR and repeat echocardiographic examination within 24 h of CMR. Echocardiographic examinations were analyzed offline with speckle tracking imaging software. Thirty-two patients with acute perimyocarditis and myopericarditis were included. Mean age was 29 ± 8, 30 males. All patients presented with chest pain and an abnormal electrocardiogram, in 28 ST elevation was found. Troponin was elevated in 30 and was 0.7 ± 0.5 ng/ml. Creatine kinase was 487 ± 319 U. LVEF was 56 ± 5%. Wall motion abnormalities were present in postero-lateral (53%), and inferior wall (21%). Delayed enhancement on CMR was found in 29 patients. Echocardiographic EF based on speckle tracking imaging correlated with CMR calculated EF. There was a positive correlation between the amplitude of regional strain and delayed enhancement, r = 0.52. Sensitivity and specificity of regional strain for prediction of delayed enhancement was 85 and 73% respectively. Speckle tracking imaging can help in the diagnosis of acute myocarditis when CMR is not readily available. Speckle tracking imaging based EF correlates with CMR calculated LVEF and with global strain.

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    Authors and Affiliations

    1. Department of Cardiology, Assaf Harofeh Medical Center, 70300, Tzrifin, Israel

      Marina Leitman, Zvi Vered, Vladimir Tyomkin, Gil Moravsky & Eli Peleg

    2. Department of Radiology, Assaf Harofeh Medical Center, 70300, Tzrifin, Israel

      Boris Macogon & Laurian Copel

    3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

      Marina Leitman, Zvi Vered, Boris Macogon, Gil Moravsky, Eli Peleg & Laurian Copel

    Authors
    1. Marina Leitman
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    2. Zvi Vered
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    3. Vladimir Tyomkin
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    4. Boris Macogon
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    5. Gil Moravsky
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    6. Eli Peleg
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    7. Laurian Copel
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    Correspondence to Marina Leitman.

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    The authors declare that they have no conflict of interests.

    Ethical approval

    Our study was approved by the local Helsinki Committee and was done in accordance with the ethical standards of the local Helsinki Committee.

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    Informed consent was obtained from all individual participants included in the study.

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    Marina Leitman and Zvi Vered have contributed equally to the manuscript.

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    Cite this article

    Leitman, M., Vered, Z., Tyomkin, V. et al. Speckle tracking imaging in inflammatory heart diseases. Int J Cardiovasc Imaging 34, 787–792 (2018). https://doi.org/10.1007/s10554-017-1284-y

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    • DOI: https://doi.org/10.1007/s10554-017-1284-y

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