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Open Access 02-09-2023 | Myocarditis | Cardiac

Effect of late gadolinium enhancement on left atrial impairment in myocarditis patients

Authors: Riccardo Cau, Giuseppe Muscogiuri, Francesco Pisu, Lorenzo Mannelli, Sandro Sironi, Jasjit S. Suri, Gianluca Pontone, Luca Saba

Published in: European Radiology | Issue 3/2024

Abstract

Objective

The aims of our study were to investigate the effect of the extent and location of late gadolinium enhancement (LGE) on the left atrium (LA) function in patients with acute myocarditis (AM) using cardiovascular magnetic resonance (CMR).

Method

This retrospective study performed CMR scans in 113 consecutive patients (89 males, 24 females; mean age 45.8 ± 17.3 years) with AM that met the updated Lake Louise criteria. Reservoir, conduit, and booster LA functions were analyzed by CMR feature tracking using dedicated software. Besides LA strain measurements, myocardial scar location and extent were assigned and quantified by LGE imaging.

Results

AM patients with septal LGE had impaired reservoir, conduit, and conduit strain rate function in comparison with AM patients with non-septal LGE (p = 0.001, for all). In fully adjusted multivariable linear regression, reservoir and conduit were significantly associated with left ventricle (LV) LGE location (β coefficient = 8.205, p = 0.007; β coefficient = 5.185, p = 0.026; respectively). In addition, LA parameters decreased according to the increase in the extent of LV fibrosis (LGE ≤ 10%; LGE 11–19%; LGE ≥ 20%). After adjustment in multivariable linear regression, the association with LV LGE extent was no longer statistically significant.

Conclusion

In patients with acute myocarditis, LA function abnormalities are significantly associated with LV LGE location, but not with LGE extent. Septal LGE is paralleled by a deterioration of LA reservoir and conduit function.

Clinical relevance statement

Left atrium dysfunction is associated with the presence of late gadolinium enhancement in the left ventricle septum and can be useful in the clinical prognostication of patients with acute myocarditis, allowing individually tailored treatment.

Key Points

• Myocardial fibrosis is related to atrial impairment.

• The location of myocardial fibrosis is the main determinant of atrial dysfunction in myocarditis patients.

• The quantification of atrial mechanisms may provide more in-depth insight into myocarditis pathophysiology.

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Title: Effect of late gadolinium enhancement on left atrial impairment in myocarditis patients
Authors: Riccardo Cau
Giuseppe Muscogiuri
Francesco Pisu
Lorenzo Mannelli
Sandro Sironi
Jasjit S. Suri
Gianluca Pontone
Luca Saba
Publication date: 02-09-2023
Publisher: Springer Berlin Heidelberg
Keyword: Myocarditis
Published in: European Radiology / Issue 3/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10176-3

2024 ASCO Annual Meeting

Springer Medicine

Effect of late gadolinium enhancement on left atrial impairment in myocarditis patients

Abstract

Objective

Method

Results

Conclusion

Clinical relevance statement

Key Points

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Method

Results

Conclusion

Clinical relevance statement

Key Points

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