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Assessing Myocardial Recovery and Ventricular Remodeling After Acute Myocarditis
Session:
Sessão de Posters 11 - Miocardite Aguda
Speaker:
Rafael Silva Teixeira
Congress:
CPC 2024
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.4 Myocardial Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Rafael Silva Teixeira; Ines Neves; Marta Almeida; Fábio Nunes; Marta Leite; André Lobo; Ines Rodrigues; Antonio Gonçalves; Mariana Brandão; Daniel Caeiro; Nuno Dias Ferreira; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:"Avenir Book"">BACKGROUND: Cardiovascular magnetic resonance (CMR) imaging is a standard diagnostic tool for acute myocarditis. However, the natural history of CMR-based tissue markers and their prognostic value for left ventricular recovery remain inadequately characterized. This retrospective study aims to elucidate the progression of CMR-based myocardial injury and chamber remodeling in patients with suspected acute myocarditis.</span></span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:"Avenir Book"">METHODS: We reviewed data from 124 consecutive patients admitted with clinically suspected acute myocarditis between January 2014 and October 2023, who exhibited CMR findings consistent with the Lake-Louise criteria. A subgroup of 49 patients with available follow-up (FUP) CMR assessments underwent quantitative comparisons of left ventricular (LV) chamber volumes, LV ejection fraction (LVEF), and the extent of myocardial late gadolinium enhancement (LGE) at baseline and FUP using predefined criteria. The primary outcomes were defined as an improvement in LVEF of at least 10% and an increase in indexed left ventricular end-diastolic volume of at least 10% at the follow-up assessment.</span></span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:"Avenir Book"">RESULTS: The mean age of the cohort was 36 ± 13 years, with the majority being male (85%). No clinical differences were noted between patients who underwent FUP CMR and those who did not. The baseline LVEF was 57% with an interquartile range (IQR) of 53 to 63. The median number of LV segments with visually-determined LGE was 6 (IQR: 4 to 8). LVEF significantly improved from 57±9% to 62±9% (mean difference: 5±12%; p<0.001), after a median FUP of 11 months (IQR: 7 to 18). LV volumes remained unchanged. The extent of LGE decreased from 39±21% to 26±20% (p=0.0001) but it was not associa. Multivariable logistic regression analysis, used to predict binary LVEF-based outcomes, adjusted the total LGE (%) for baseline LVEF. NTproBNP was the only biomarker associated with LVEF change (Odds Ratio per doubling of NTproBNP: 0.51; 95% CI: 0.26 to 0.96; p=0.04). Troponin and inflammatory markers did not reach statistical significance.</span></span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:"Avenir Book"">CONCLUSIONS:</span> <span style="font-family:"Avenir Book"">In patients with clinically suspected acute myocarditis, significant reductions in CMR-based tissue injury markers were observed within the first year of recovery. The study found that baseline levels of NT-proBNP were inversely associated with improvements in LVEF, suggesting its potential as a predictive biomarker for cardiac recovery. </span></span></span></span></p>
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