Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Left Atrial Strain Derived From Cardiac Magnetic Resonance Imaging Can Predict Outcomes of Patients With Acute Myocarditis

  • Jimin Lee (Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Ki Seok Choo (Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Yeon Joo Jeong (Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Geewon Lee (Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Minhee Hwang (Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute) ;
  • Maria Roselle Abraham (Department of Cardiology, University of California) ;
  • Ji Won Lee (Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute)
  • Received : 2022.11.16
  • Accepted : 2023.03.10
  • Published : 2023.06.01
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Abstract

Objective: There is increasing recognition that left atrial (LA) strain can be a prognostic marker of various cardiac diseases. However, its prognostic value in acute myocarditis remains unclear. Therefore, this study aimed to evaluate whether cardiovascular magnetic resonance (CMR)-derived parameters of LA strain can predict outcomes in patients with acute myocarditis. Materials and Methods: We retrospectively analyzed the data of 47 consecutive patients (44.2 ± 18.3 years; 29 males) with acute myocarditis who underwent CMR in 13.5 ± 9.7 days (range, 0-31 days) of symptom onset. Various parameters, including feature-tracked CMR-derived LA strain, were measured using CMR. The composite endpoints included cardiac death, heart transplantation, implantable cardioverter-defibrillator or pacemaker implantation, rehospitalization following a cardiac event, atrial fibrillation, or embolic stroke. The Cox regression analysis was performed to identify associations between the variables derived from CMR and the composite endpoints. Results: After a median follow-up of 37 months, 20 of the 47 (42.6%) patients experienced the composite events. In the multivariable Cox regression analysis, LA reservoir and conduit strains were independent predictors of the composite endpoints, with an adjusted hazard ratio per 1% increase of 0.90 (95% confidence interval [CI], 0.84-0.96; P = 0.002) and 0.91 (95% CI, 0.84-0.98; P = 0.013), respectively. Conclusion: LA reservoir and conduit strains derived from CMR are independent predictors of adverse clinical outcomes in patients with acute myocarditis.

Keywords

Acknowledgement

We acknowledge the assistance of Kwang Min Lee (KM consulting) with the statistical analysis.

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