Predictors of the presence of septal late gadolinium enhancement in follow-up cardiac magnetic resonance imaging and its relation to acute myocarditis prognosis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute myocarditis (AM) is generally a self-limited and benign disease. However, minority patients (pts) present or develop adverse outcomes. It has been proposed that the presence late gadolinium enhancement (LGE) in septum associated with worse prognosis. Also, LGE without oedema follow-up cardiac magnetic resonance imaging (CMR) seems to reflect more permanent lesions. Purpose The aim this study was determine if septal acute-phase CMR higher extent disease initial laboratory tests help predict evolution Methods Prospective single-centre pts admitted AM diagnosed according clinical findings, troponin T elevation criteria (Lake Louise), since 1/2013. Selection those who underwent (CMR-I) (CMR-II). Results Of 88 AM, 46 fulfilled our inclusion criteria: median age 31 ± 13 years, 85% males. CMR-I performed at 6 5days 43 (93.5%). CMR-II 8 4.3 months 29 (63%) improved number LGE-positive segments, 10 (21.8%) had stable 7 (15.2%) worsened findings. Septal-LGE detected (21.7%) (13.0%) CMR-II. Logistic regression analysis identified septal-LGE as predictor (OR 1.4, 95%CI 1.1-1.9, p = 0.020). Although values maximum high-sensitivity reactive-C protein (RCP) were not CMR-I, increasing such univariate predictors likelihood involvement CMR-II: (886 vs 1852ng/L; OR 1.00, 1.00-1.00 0.017) RCP (4.2 13.9mg/dL; 1.17, 1.04-1.33, 0.012). After multivariate analysis, independent (AUC 80.8, 0.97-0.91, cut-off value >10.2mg/dL sensitivity specificity 83.3% 85.0%, respectively. cardiovascular risk factors, presentation B-type natriuretic peptide either CMR. In mean 757 476days, no patient died, 3 (6.5%) developed new-onset heart failure (NYHA class II functional symptoms) 2 (4.3%) ventricular arrhythmias. Due small events, neither nor pattern predicted Conclusions population, able Increased biomarkers inflammatory proteins acute setting also can potentially establish events for myocarditis.