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Implications of Septal Late Gadolinum Enhancement in patients with Acute Myocarditis
Session:
Posters (Sessão 1 - Écran 7) - Miscelânea - Vários Temas
Speaker:
Gonçalo Rm Ferreira
Congress:
CPC 2022
Topic:
P. Other
Theme:
37. Miscellanea
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Gonçalo rm Ferreira; Luísa Gonçalves; Inês Pires; João Miguel Santos; Joana Correia; Vanda Neto; João Fiuza; João Corrêa; Gabriela Venade; Bruno Marmelo; Miguel Correia; Costa Cabral
Abstract
<p>Introduction: Acute myocarditis (AM) is an inflammatory disease of the heart muscle, usually with a benign clinical course. Recent and conflicting data suggest that myocardial septal late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) may be associated with a worse prognosis.</p> <p>Objective: The aim of the present study was to evaluate the prevalence and prognostic implications of septal LGE in AM. </p> <p>Methods: Selected all patients admitted in five consecutive years in a Cardiology ward, with AM diagnosis by the Lake-Louise criteria on CMR. Division in two groups: Group A – AM with septal LGE; and Group B - AM without septal LGE. Comparison between the groups in terms of clinical, blood analysis, and cardiac imaging on admission, and significant events on follow-up, like mortality, rehospitalization, and left ventricular ejection fraction (LVEF) by echocardiography. Follow-up of up to 2-years. Groups were compared using the student T-test and Pearson’s Chi-Square.</p> <p>Results: 82 patients were selected, 87.8 % male (n=72) with mean age of 31 [18-74 years]. 26.8% in Group A (n=22). In terms of follow-up, 90.2% (n=74) of the patients completed the 2-year clinical follow-up, but only 56% (n=46) of them had the echocardiography assessments available at two years follow-up. In comparison with Group B, Group A was composed more frequently by women (27.3% vs 6.7%, p=0.012), presentation with syncope (9.1% vs 0.0%, p=0.018), and ventricular tachycardia on ECG (9.1% vs 0.0%, p=0.018), a superior length of stay (8±0.9 vs 6±0.4 days, p=0.012), no difference on the admission troponin, but a higher troponin peak (31630±13259 vs 18634±2035ng/L, p=0.001), lower serum creatinine (0.79±0.05 vs 0.82±0.01mg/dL, p=0.023). There was no difference in the assessment of LVEF by echocardiogram on the acute episode (A: 59.5±1.6 vs 58.3±1.2, p=0.4), but in the follow-up, Group A had lower LVEF (60.5±1.8 vs 66.5±0.8, p=0.04). No patient died during the follow-up, and there was no difference in morbidity during the follow-up (dysrhythmias, dilated cardiomyopathy, implantable cardioverted defibrillator/pacemaker, heart transplant). A total of 10 patients were readmitted due to recurrent MC in the two-year follow-up, but without differences between groups.</p> <p>Discussion: AM with septal LGE seems to be associated with clinical and analytical features that are already known to be associated with a worse prognosis in AM. It would be important to access the prognosis on a longer follow-up because, although during the 2 years follow-up no clinical adverse event was recorded, septal LGE was associated with a lower LVEF.</p>
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