Korean J Radiol.  2023 Jun;24(6):512-521. 10.3348/kjr.2022.0898.

Left Atrial Strain Derived From Cardiac Magnetic Resonance Imaging Can Predict Outcomes of Patients With Acute Myocarditis

• Lee J
• Choo KS
• Jeong YJ
• Lee G
• Hwang M
• Abraham MR
• Lee JW

• KMID: 2542859
• DOI: http://doi.org/10.3348/kjr.2022.0898

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.

Keyword

Myocarditis; Magnetic resonance imaging; Major adverse cardiovascular events; Left atrium