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The International Journal of Cardiovascular Imaging

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01-12-2019 | Myocarditis | Original Paper

Diagnostic and prognostic value of cardiac magnetic resonance in acute myocarditis: a systematic review and meta-analysis

Authors: Sarah Blissett, Yehuda Chocron, Bojan Kovacina, Jonathan Afilalo

Published in: The International Journal of Cardiovascular Imaging | Issue 12/2019

Abstract

While diagnostic criteria were elaborated for acute myocarditis using cardiac magnetic resonance (CMR) in 2009, studies have since examined the yield of traditional and novel CMR parameters to achieve greater accuracy and to predict clinical outcomes. The purpose of this systematic review and meta-analysis was to determine the diagnostic and prognostic value of CMR parameters for acute myocarditis. MEDLINE and EMBASE were systematically searched for original studies that reported CMR parameters in adult patients suspected of acute myocarditis. Each CMR parameter's binary prevalence, mean value and standard deviation were extracted. Parameters were meta-analyzed using a random-effects model to generate standardized mean differences. After screening 1492 abstracts, 53 studies were included encompassing 2823 myocarditis patients and 803 controls. Pooled standardized mean differences between myocarditis patients and controls were: T2 mapping time 2.26 (95% CI 1.50–3.02), extracellular volume 1.64 (95% CI 0.87–2.42), LGE percentage 1.30 (95% CI 0.95–1.64), T1 mapping time 1.18 (95% CI 0.35–2.01), T2 ratio 1.17 (95% CI 0.80–1.54), and EGE ratio 0.93 (95% CI 0.66–1.19). Prolonged T1 mapping time had the highest sensitivity (82%), pericardial effusion had the highest specificity (99%). Baseline LV dysfunction and the presence of LGE were predictive of major adverse cardiac events. The results support integration of parametric mapping criteria in the diagnostic criteria for myocarditis. The presence of baseline LV dysfunction and LGE predict patients at higher risk of adverse events.

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Title: Diagnostic and prognostic value of cardiac magnetic resonance in acute myocarditis: a systematic review and meta-analysis
Authors: Sarah Blissett
Yehuda Chocron
Bojan Kovacina
Jonathan Afilalo
Publication date: 01-12-2019
Publisher: Springer Netherlands
Keyword: Myocarditis
Published in: The International Journal of Cardiovascular Imaging / Issue 12/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-019-01674-x

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