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Article

More than 50% of Persistent Myocardial Scarring at One Year in “Infarct-like” Acute Myocarditis Evaluated by CMR

1
Department of Cardiology, CHU Dijon-Bourgogne, 14 rue Gaffarel, CEDEX, 21079 Dijon, France
2
Department of MRI, CHU, 21000 Dijon, France
3
Laboratory ImVIA, EA 7535, University of Burgundy, 21000 Dijon, France
*
Author to whom correspondence should be addressed.
Academic Editors: Andrea Frustaci and Bernward Lauer
J. Clin. Med. 2021, 10(20), 4677; https://doi.org/10.3390/jcm10204677
Received: 21 August 2021 / Revised: 29 September 2021 / Accepted: 6 October 2021 / Published: 13 October 2021
(This article belongs to the Special Issue Myocarditis in Clinical Practice)
Background: Cardiac magnetic resonance (CMR) has emerged as a reference tool for the non-invasive diagnosis of myocarditis. However, its role in follow-up (FU) after the acute event is unclear. The objectives were to assess the evolution of CMR parameters between the acute phase of infarct-like myocarditis and 12 months thereafter and to identify the predictive factors of persistent myocardial scarring at one year. Methods: All patients with infarct-like acute myocarditis confirmed by CMR were included. CMR was performed within 8 days following symptom onset, at 3 months and at one year. One-year FU included ECG, a cardiac stress test, Holter recording, biological assessments, medical history and a quality-of-life questionnaire. Patients were classified according to the presence or absence of complete recovery at one year based on the CMR evaluation. Results: A total of 174 patients were included, and 147 patients had three CMR. At one year, 79 patients (54%) exhibited persistent myocardial scarring on CMR. A multivariate analysis showed that high peak troponin at the acute phase (OR: 3.0—95%CI: 1.16–7.96—p = 0.024) and the initial extent of late gadolinium enhancement (LGE) (OR: 1.1—95%CI: 1.03–1.19—p = 0.006) were independent predictors of persistent myocardial scarring. Moreover, patients with myocardial scarring on the FU CMR were more likely to have premature ventricular contractions during the cardiac stress test (25% versus 9%, p = 0.008). Conclusion: Less than 50% of patients with infarct-like acute myocarditis showed complete recovery at one year. Although major adverse cardiac events were rare, ventricular dysrhythmias at one year were more frequent in patients with persistent myocardial scarring. View Full-Text
Keywords: acute myocarditis; cardiac magnetic resonance; one year follow-up acute myocarditis; cardiac magnetic resonance; one year follow-up
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MDPI and ACS Style

Pommier, T.; Leclercq, T.; Guenancia, C.; Tisserand, S.; Lairet, C.; Carré, M.; Lalande, A.; Bichat, F.; Maza, M.; Zeller, M.; Cochet, A.; Cottin, Y. More than 50% of Persistent Myocardial Scarring at One Year in “Infarct-like” Acute Myocarditis Evaluated by CMR. J. Clin. Med. 2021, 10, 4677. https://doi.org/10.3390/jcm10204677

AMA Style

Pommier T, Leclercq T, Guenancia C, Tisserand S, Lairet C, Carré M, Lalande A, Bichat F, Maza M, Zeller M, Cochet A, Cottin Y. More than 50% of Persistent Myocardial Scarring at One Year in “Infarct-like” Acute Myocarditis Evaluated by CMR. Journal of Clinical Medicine. 2021; 10(20):4677. https://doi.org/10.3390/jcm10204677

Chicago/Turabian Style

Pommier, Thibaut, Thibault Leclercq, Charles Guenancia, Simon Tisserand, Céline Lairet, Max Carré, Alain Lalande, Florence Bichat, Maud Maza, Marianne Zeller, Alexandre Cochet, and Yves Cottin. 2021. "More than 50% of Persistent Myocardial Scarring at One Year in “Infarct-like” Acute Myocarditis Evaluated by CMR" Journal of Clinical Medicine 10, no. 20: 4677. https://doi.org/10.3390/jcm10204677

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