Universität zu Köln

Baessler, Bettina ORCID: 0000-0002-3244-3864, Schaarschmidt, Frank, Dick, Anastasia, Michels, Guido, Maintz, David and Bunck, Alexander C. (2016). Diagnostic implications of magnetic resonance feature tracking derived myocardial strain parameters in acute myocarditis. Eur. J. Radiol., 85 (1). S. 218 - 228. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: The present study aims to evaluate the diagnostic value of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain-analysis of both ventricles in patients with acute myocarditis (ACM) in order to improve its currently still challenging non-invasive diagnosis. Methods: CMR cine data of 31 patients with clinically suspected ACM and confirmation of diagnosis by CMR according to the Lake Louise criteria as well as 14 patients with clinically diagnosed ACM but inconspicuous CMR were retrospectively analyzed. 20 healthy volunteers (HV) served as a control. Analysis of global longitudinal, circumferential and radial strain and strain rate of both ventricles was performed in one long-axis and three short-axis slices using a dedicated FT-software (TomTec Imaging Systems). Results: Patients with ACM showed significantly reduced LV longitudinal strain (-12.7 +/- 6.5 vs. -16.8 +/- 5.9%, p = 0.021) and LV circumferential strain (LVCirStrain; 22.9 +/- 5.7 vs. 27.8 +/- 4.4 %, p < 0.001) compared to HV. Conversely, they showed improved basal RV circumferential strain rate (BasaIRVCirSR; 0.70 +/- 0.23 vs. 0.47 +/- 0.31 s(-1), p = 0.009). In ACM patients with preserved EF, BasaIRVCirSR was significantly increased compared to HV while LV strain was not significantly different between both groups. In multinominal logistic regression analysis, LVCirStrain and BasaIRVCirSR proved to be the best independent predictors of ACM with preserved EF. A combined cut-off of 0.53 s(-1) for BasaIRVCirSR and of 29.0% for LVCirStrain allowed a classification of ACM patients with preserved EF with a sensitivity of 89% and a specificity of 80%. Also patients with clinical ACM but inconspicuous CMR showed a significantly improved BasaIRVCirSR and a cut-off of 0.77 s(-1) allowed a classification of ACM patients with a sensitivity of 70% and a specificity of 90%, while all other CMR parameters were normal. Conclusions: The defined cut-offs for LVCirStrain and BasaIRVCirSR allow a prediction of ACM with high sensitivity and specificity, even in patients with preserved EF and in patients with otherwise completely inconspicuous CMR. Our results point to a discriminative power especially of RV strain analysis in the CMR-based diagnosis of ACM. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Baessler, Bettina UNSPECIFIED orcid.org/0000-0002-3244-3864 UNSPECIFIED Schaarschmidt, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Dick, Anastasia UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-291964
DOI:	10.1016/j.ejrad.2015.11.023
Journal or Publication Title:	Eur. J. Radiol.
Volume:	85
Number:	1
Page Range:	S. 218 - 228
Date:	2016
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ECHOCARDIOGRAPHIC SPECKLE TRACKING; 2-DIMENSIONAL STRAIN; CMR; DEFORMATION; CARDIOMYOPATHY; PERFORMANCE; MANAGEMENT; SOCIETY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29196