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Research Advances in Myocardial Injury

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (6 April 2025) | Viewed by 834

Special Issue Editor


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Guest Editor
Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria “Policlinico G. Martino” and Universita’ degli Studi di Messina, Messina, Italy
Interests: echocardiography; cardiac intensive care unit; myocardial injury

Special Issue Information

Dear Colleagues,

Over the last decade, cardiac troponin (cTn) assays have allowed for a relevant improvement in the detection of myocardial infarction (MI), leading to the timely and more effective management of these patients, particularly when affected by MI without ST-segment elevation. However, cTn is not specific for ischemic heart disease and can be potentially released in various cardiac and non-cardiac diseases. cTn, indeed, is solely a marker of myocardial injury, which is defined as a rise and/or fall in cTn in the absence of signs and symptoms of MI, which has been defined in the Fourth Universal Definition of Myocardial Infarction. In this setting, new technologies, in the field of echocardiography, may be of particular value in distinguishing between ischemic and non-ischemic sources of cTn rise. In this Special Issue, we welcome authors to submit papers on the clinical advances related to myocardial injury, providing useful insights to differentiate between ischemic and non-ischemic causes of increase in cTn.

Dr. Maurizio Cusmà Piccione
Guest Editor

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Keywords

  • myocardial injury
  • cardiac troponin
  • myocardial infarction
  • heart failure
  • rise and fall
  • longitudinal strain

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Published Papers (1 paper)

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31 pages, 7069 KiB  
Systematic Review
Clinical Significance of Extracellular Volume of Myocardium (ECV) Assessed by Computed Tomography: A Systematic Review and Meta-Analysis
by Adrian Martuszewski, Patrycja Paluszkiewicz, Rafał Poręba and Paweł Gać
J. Clin. Med. 2025, 14(6), 2066; https://doi.org/10.3390/jcm14062066 - 18 Mar 2025
Viewed by 559
Abstract
Background/Objectives: Extracellular volume (ECV) of the myocardium, a biomarker of interstitial space and fibrosis, plays a critical role in cardiac disease diagnosis and prognosis. Although cardiac magnetic resonance imaging (MRI) is the gold standard for ECV assessment, computed tomography (CT) offers a [...] Read more.
Background/Objectives: Extracellular volume (ECV) of the myocardium, a biomarker of interstitial space and fibrosis, plays a critical role in cardiac disease diagnosis and prognosis. Although cardiac magnetic resonance imaging (MRI) is the gold standard for ECV assessment, computed tomography (CT) offers a viable alternative, particularly in patients with contraindications to MRI. This study aimed to assess whether CT-derived ECV is systematically elevated in cardiac diseases associated with myocardial fibrosis. Methods: A systematic search of PubMed and Web of Science up to January 2023 identified 364 studies, including 16 from registers and 4 from manual searches. After exclusions, 73 studies were included in the systematic review. Of these, 15 provided quantitative data on group sizes, mean ECV values, standard deviations, and imaging modalities (CTA, DECT, LIE-DECT) and were analyzed in the meta-analysis. Standardized mean differences (SMD) were calculated using Cochrane Handbook formulas. Statistical analyses employed random-effects models (R version 4.4.2). Results: The pooled analysis showed that ECV was significantly higher in pathological groups compared to controls (SMD 1.60; 95% CI: 1.23–1.96; I2 = 84.6%). Elevated ECV correlated with worse clinical outcomes, including higher mortality in heart failure and advanced myocardial fibrosis in amyloidosis and cardiomyopathies. Subgroup analyses demonstrated that advanced CT techniques (DECT, LIE-DECT) and CTA provided comparable diagnostic accuracy. Conclusions: CT-derived ECV is a reliable, non-invasive marker of myocardial fibrosis, offering diagnostic and prognostic value similar to MRI. Standardizing CT protocols and conducting multicenter studies are essential to validate its broader clinical application. Full article
(This article belongs to the Special Issue Research Advances in Myocardial Injury)
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