Performance of native and contrast-enhanced T1 mapping to detect myocardial damage in patients with suspected myocarditis: a head-to-head comparison of different cardiovascular magnetic resonance techniques
AbstractMyocardial T1 mapping is a novel technique that has proven to be superior to standard imaging for differentiation between healthy individuals in acute myocarditis. Aim of this study was comparison of T1 mapping with a clinical biomarker. We retrospectively investigated 171 patients undergoing cardiovascular magnetic resonance (CMR) examination with suspected myocarditis by performing native and contrast enhanced T1-mapping. Additionally, T2w and T1w images and late gadolinium enhancement sequences (LGE) were utilized for myocardial evaluation; Lake Louise Criteria comprise T1w, T2w and LGE imaging in a score. Reference for positive myocarditis diagnosis was a ten-fold increase of troponin level above normal (0.14 ng/ml). Native T1 and extracellular volume (ECV) showed good association with relevant troponin elevations. Area under the curve (AUC) was 81% (p = 0.0001) for native T1 with an optimal threshold of 979 ms and 86% (p
Conditions: COVID; Acute Coronary Syndrome; Myocardial Infarction; Myocarditis; Venous Thromboembolism; Deep Vein Thrombosis; Pulmonary Embolism Intervention: Sponsor: Centre Hospitalier Universitaire de Nice Recruiting
AbstractCancer therapies have been evolving from conventional chemotherapeutics to targeted agents. This has fulfilled the hope of greater efficacy but unfortunately not of greater safety. In fact, a broad spectrum of toxicities can be seen with targeted therapies, including cardiovascular toxicities. Among these, cardiomyopathy and heart failure have received greatest attention, given their profound implications for continuation of cancer therapies and card iovascular morbidity and mortality. Prediction of risk has always posed a challenge and even more so with the newer targeted agents. The merits of...
Based on reports from China, we know that most COVID-19 patients (about 80%) will develop mild flulike symptoms, including fever, dry cough, and body aches that can be managed at home. 20% will develop more serious symptoms, such as pneumonia requiring hospitalization, with about a quarter of these requiring ICU-level care. Initial reports focused on the respiratory effects of COVID-19, such as pneumonia and difficulty breathing. But more recent literature has described serious cardiovascular complications occurring in about 10% to 20% of hospitalized patients. Someone with pre-existing heart disease who becomes ill with C...
This review highlights that coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias, and that CV risk factors should be judiciously controlled per evidence-based guidelines.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. Recent reports indicate risk for fulminant myocarditis in non-transplant patients and severe, potentially fatal rejection in transplant recipients treated with ICIs. As the use of ICIs is expanding, there is an imperative to address gaps in our understanding of risk for ICI use in the post-transplant patient. The aim of this submission is to highlight a case series of thoracic transplant patients treated with ICIs and to introduce a clinical registry of ICI use.
Myocarditis is a known etiology of both acute fulminant heart failure and chronic dilated cardiomyopathy requiring heart transplantation. We sought to evaluate the long-term post-transplant outcomes of pts with myocarditis.
We report an outcome case-series of 7 transplanted patients with excellent outcomes with an aggressive management strategy.
Myocarditis is one major cause for the development of acute or chronic heart failure where immunosuppressive therapies are still divergently discussed. The aim of this study was to analyze cytokines in children with suspected myocarditis to describe their immunologic patterns and to reveal potential therapeutic targets.
Giant cell myocarditis (GCM) is a rare, serious form of myocarditis that can require bridging to orthotopic heart transplant (OHT) with mechanical circulatory support (MCS). Given that the roles of MCS and immunosuppressive therapy have not been well defined in this patient population, we sought to analyze the outcomes of patients with GCM who required MCS.
Fulminant viral myocarditis (FVM) is a rare cause of cardiogenic shock due to severe myocardial inflammation induced by inappropriately activated immune system. For years, a biased study with 15 patients has maintained the myth that FVM has an excellent prognosis but recent literature clearly shows a high morbidity with need for mechanical circulatory support (MCS) up to 60% and mortality rates between 12 to 45%. Owing to this high mortality, acute immunosuppressive therapy for FVM gained in popularity and was described in numerous retrospective studies, with a combined overall mortality under 5%.