Alba De Vita MD, Abstract Co-Author: Nothing to Disclose

Carmela Napolitano MD, Abstract Co-Author: Nothing to Disclose

Vittorio Semeraro MD, Abstract Co-Author: Nothing to Disclose

Agostino Meduri MD, Abstract Co-Author: Nothing to Disclose

Luigi Natale MD, Presenter: Nothing to Disclose

Lorenzo Bonomo MD, Abstract Co-Author: Nothing to Disclose

Exact incidence of myocarditis is unknown as diagnosis is frequently delayed or missed. Clinical presentation is variable: acute syndrome, heart failure, arrhythmias and cardiogenic shock can be possible. Aim of the study was to identify prognostic factors on MRI at presentation, in pts with bioptically proven myocarditis.

56 pts with pathological diagnosis of myocarditis underwent echocardiography with TDI and MRI with Gd-chelates injection, at presentation and after 6 months, to evaluate biventricular systolic function and DE pattern. 20 pts (36%) presented with acute coronary syndrome, 16 pts (28%) with arrhythmias and 20 (36%) with heart failure. In all pts. biopsy confirmed active lymphocitic myocarditis, with viral genoma of parvovirus in 16.

Negative remodelling was defined as end-systolic volume increase > 10% and occurred in 4 out of 20 pts (20%) with acute presentation, in 8 out of 16 pts (50%) with arrhythmias, and in 14 out of 20 pts (67%) with heart failure. Total number of pts. with negative remodelling was 26 out of 56 (46%). DE was observed more frequently in pts. with negative remodelling (21 pts, 88%) than in pts. with positive remodelling (14 pts, 61%). In acute presentations DE was observed in 16 out of 20 pts with lateral subepicardial or patchy intramural pattern, while it was present in 12 out of 20 heart failure pts and in 6 out of 16 arrythmias pts, both with midwall septal pattern.

DE was more frequently observed at presentation in negatively remodelled ventricles. Furthermore DE patterns correlate with clinical presentation and midwall pattern can predict negative remodelling.

Acute presentations with or without DE less frequently evolve in negative remodelling.

De Vita, A, Napolitano, C, Semeraro, V, Meduri, A, Natale, L, Bonomo, L, Prognostic Value of Delayed Enhancement at MRI in Myocarditis: Correlation with Clinical Presentation.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012967.html