Two-dimensional and three-dimensional cardiac magnetic resonance feature-tracking myocardial strain analysis in acute myocarditis patients with preserved ejection fraction
To explore the potential role of two- (2D) and three-dimensional (3D) cardiac magnetic resonance (CMR) feature tracking (FT) myocardial strain analysis in identifying sub-clinical myocardial systolic and diastolic dysfunction in acute myocarditis patients with preserved ejection fraction (EF). Prospective two centre study-control study. Thirty patients (9 female, 37.2 ± 11.8 years.) with a CMR diagnosis of acute myocarditis according to the Lake Louise Criteria and preserved EF (≥ 55%) were included in the analysis. CMR data from 24 healthy volunteers (11 female, 36.2 ± 12.5 years.) served as control. 2D and 3D LV tissue tracking analysis were performed in a random fashion by two double-blinded operators. Variables were checked for normality and analysed with parametric test. The baseline characteristics of myocarditis patients with preserved EF and the healthy volunteers were perfectly comparable, except for the LV mass index and T1 and T2 mapping values (p < 0.001). The results of the interobserver variability in the 2D and 3D LV CMR FT myocardial strain analysis were p > 0.42, ICC > 0.80 and η2 > 0.98. There was no statistical difference in 2D and 3D global radial, circumferential and longitudinal strain peak (%) and both systolic and diastolic strain rate (1/s) between acute myocarditis with preserved EF and healthy volunteers (all p = ns). There were no difference in 2D and 3D global radial, circumferential and longitudinal strain peak and both systolic and diastolic strain rate of the LV between acute myocarditis patients with preserved ejection fraction and healthy volunteers.
KeywordsCardiovascular magnetic resonance Acute myocarditis Feature tracking Myocardial strain analysis Diastolic dysfunction
This research was partially supported by a grant from the Italian Ministry of Health: “Giovani Ricercatori—Ricerca Finalizzata”, project number GR-2013-02356832. The funder had no role in this study.
Compliance with ethical standards
Conflict of interest
All the authors are aware of the content of the manuscript and have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 13.Doerner J, Bunck AC, Michels G et al (2018) Incremental value of cardiovascular magnetic resonance feature tracking derived atrial and ventricular strain parameters in a comprehensive approach for the diagnosis of acute myocarditis. Eur J Radiol 104:120–128. https://doi.org/10.1016/j.ejrad.2018.05.012 CrossRefGoogle Scholar
- 18.Caforio ALP, Pankuweit S, Arbustini E et al (2013) Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European society of cardiology working group on myocardial and pericardial diseases. Eur Heart J 34(2636–2648):2648. https://doi.org/10.1093/eurheartj/eht210 Google Scholar
- 21.Messroghli DR, Moon JC, Ferreira VM et al (2017) Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the society for cardiovascular magnetic resonance (SCMR) endorsed by the European association for cardiovascular imaging (EACVI). J Cardiovasc Magn Reson 19:75. https://doi.org/10.1186/s12968-017-0389-8 CrossRefGoogle Scholar
- 23.Schulz-Menger J, Bluemke DA, Bremerich J et al (2013) Standardized image interpretation and post processing in cardiovascular magnetic resonance: society for cardiovascular magnetic resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 15:35. https://doi.org/10.1186/1532-429X-15-35 CrossRefGoogle Scholar
- 25.Kempny A, Fernández-Jiménez R, Orwat S et al (2012) Quantification of biventricular myocardial function using cardiac magnetic resonance feature tracking, endocardial border delineation and echocardiographic speckle tracking in patients with repaired tetralogy of Fallot and healthy controls. J Cardiovasc Magn Reson 14:32. https://doi.org/10.1186/1532-429X-14-32 CrossRefGoogle Scholar