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0486 : Predictive value of late gadolinium enhancement quantification with cardiac magnetic resonance imaging in acute myocarditis
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Archives of Cardiovascular Diseases Supplements (2016) 8, 252-254
Results Patients in high EAT group were significantly associated with increased body mass index and hypertension, presented a smaller infarct size (18.3±11.9 vs 23±13.7 % of total LV, p=0.041) at initial CMR assessment and after a 3-month follow-up (p=0.01), MVO occurred less frequently (36.2 vs 59.3%, p=0.006). We found no difference between EAT groups in regard to LVEF, LV volumes, SWS as well as in regard to coronary burden and clinical events during the index hospitalization or the follow-up. EAT was an independent predictor of low infarct size in univariate and multivariate analysis; B=–3.25 [–5.894; –0.615], p=0.016. Conclusion EAT volume > 33.5 ml was paradoxically related to smaller infarct size in STEMI but didn’t seem to be related to changes in LVEF, LV remodelling or further clinical events.
not identify any biomarker (troponin, CPK, or CRP) or imaging parameter (SQS) capable of predicting future cardiac events. Of note SQS was not correlated to cardiovascular (troponin: r²=0.22, p=0.001; CPK: r²=0.11, p=0.03) or inflammation (CRP: ρ=0,35, p=0.02) biomarkers. However, variation of SQS between admission and 3 months exhibited promising predictive value for adverse cardiac events with an AUC of 97,5% (sensitivity =90, specificity =74%). This analysis showed that a reduction of SQS lower than 42% was a risk factor for cardiac event. Conclusion The follow up of LGE decrease with SQS at three months is a useful tool to predict cardiovascular events in the year following an acute viral myocarditis. The author hereby declares no conflict of interest
The author hereby declares no conflict of interest
0083 Hyperhemia on the first-pass MRI perfusion for the diagnosis of acute myocarditis Samuel Zarka *, Claire Bouleti, Dimitri Arangalage, Houzefa Chopra, Guillaume Baudry, Philippe-Gabriel Steg, Alec Vahanian, Jean-Pierre Laissy, Phalla Ou APHP-Hôpital Bichat-Claude Bernard, Paris, France * Corresponding author: [email protected] (Samuel Zarka) Background MRI is the current way for the diagnosis of acute myocarditis, based on the Lake Louise criteria (presence of at least two of the three following criteria: myocardial edema, hyperaemia and/or a late Gadolinium enhancement). The first-pass perfusion sequence, used for detecting myocardial ischemia, may also be used to highlight a myocardial hyperemia in acute myocarditis. Purpose The aim of our study was to assess subepicardial hyperemia, seen on the first pass perfusion sequence by MRI, as a new method for the diagnosis of acute myocarditis.
Abstract 0094 – Figure: Example of Epicardial Adipose tissue assessment
0486 Predictive value of late gadolinium enhancement quantification with cardiac magnetic resonance imaging in acute myocarditis Heloise Prigent Manchon * (1), Nicolas Vodovar (2), Philippe Soyer (1), Alain Cohen Solal (1), Marc Sirol (1) (1) APHP-Hôpital Lariboisière, Paris, France – (2) Université ParisDiderot, INSERM 942, Paris, France * Corresponding author: [email protected] (Heloise Prigent Manchon) Introduction Prognostic factors after acute myocarditis are lacking, yielding heterogeneity in follow-up practices. We hypothesized that quantifying the late gadolinium enhancement (LGE) during cardiac magnetic resonance imaging (CMRI) could be an appealing tool to predict the risk of cardiovascular event. Objective This pilot study aimed at evaluating the variation in LGE SemiQuantitative Score (SQS) between CMRI at admission and a second CMRI three months later, as a predictive tool of adverse cardiac events following an acute viral myocarditis. Method 49 patients with acute viral myocarditis as confirmed by CMRI Lake Louise criteria were included. Patients had a second CMRI at 3 months and were followed clinically during one year. No cardiovascular event occurred between discharge and the second CMRI at three months. LGE was quantified at M0 and M3, using SQS already validated in ischemic cardiomyopathy. SQS predictive value was assessed in the acute phase and at one year using a combination of death from cardiovascular cause, heart failure or severe arrhythmias as main outcome. Results In most cases (n=39, 79,5 %), LGE decreased over the time after an acute myocarditis and rarely disappeared (n=5, 10%). At admission, we did
Method 47 patients (mean age = 42.4±15,6 years; 35 men) with acute myocarditis were included and compared to 16 healthy controls (without heart disease). The first-pass perfusion was evaluated by two blinded observers and compared to myocardial late Gadolinium enhancement, considered the reference method for the diagnosis of acute myocarditis, using both a qualitative (visual analysis) and a semi-quantitative method (ratio of the signals: infarction hyperaemia / healthy myocardium). Results 24 (51.1 %) patients with myocarditis exhibited detectable hyperemia. Qualitative analysis showed good inter-observer variability (kappa = 0.75). There was an increase of the signal intensity in the myocardium with hyperhemia as compared to the adjacent normal myocardium (myocarditis vs controls: 1.08±0.03 vs 0.95±0.05, p=0.03; myocarditis with hyperhemia vs myocarditis non hyperhemia: 1.22±0.04 vs 0.94 ±0.04, p<0.0001). The correlation between the first-pass perfusion and late Gadolinium enhancement was good (kappa = 0,70). Considering the late Gadolinium enhancement as gold standard, the calculated values of sensitivity and specificity were 85% and 94%, respectively. Conclusion Hyperhemia on the First-pass perfusion sequence, is a valuable and reproducible tool for the diagnosis of acute myocarditis. The author hereby declares no conflict of interest
0553 Assessment of myocardial deformation using multi-layer speckle tracking in patients undergoing chemotherapy: a comparison of two vendors Yann Ancedy (1), Stephane Ederhy * (1), Sylvie Lang (1), Antoine Hollebecque (2), Laurie Soulat-Dufour (1), Saroumadi Adavane-Scheuble (1), Marion Chauvet (1), Arnaud Etienney (1), Franck Boccara (1), JeanCharles Soria (2), Ariel Cohen (1) (1) APHP-Hôpital Saint-Antoine, Paris, France – (2) Centre régional de lutte contre le cancer Gustave-Roussy, Villejuif, France * Corresponding author: [email protected] (Stephane Ederhy) Background The purpose of this study was to investigate intervendor variability when measuring multilayer strain in cancer patients treated with oral chemotherapy.
© Elsevier Masson SAS. All rights reserved.
Archives of Cardiovascular Diseases Supplements (2016) 8, 252-254
Results Patients in high EAT group were significantly associated with increased body mass index and hypertension, presented a smaller infarct size (18.3±11.9 vs 23±13.7 % of total LV, p=0.041) at initial CMR assessment and after a 3-month follow-up (p=0.01), MVO occurred less frequently (36.2 vs 59.3%, p=0.006). We found no difference between EAT groups in regard to LVEF, LV volumes, SWS as well as in regard to coronary burden and clinical events during the index hospitalization or the follow-up. EAT was an independent predictor of low infarct size in univariate and multivariate analysis; B=–3.25 [–5.894; –0.615], p=0.016. Conclusion EAT volume > 33.5 ml was paradoxically related to smaller infarct size in STEMI but didn’t seem to be related to changes in LVEF, LV remodelling or further clinical events.
not identify any biomarker (troponin, CPK, or CRP) or imaging parameter (SQS) capable of predicting future cardiac events. Of note SQS was not correlated to cardiovascular (troponin: r²=0.22, p=0.001; CPK: r²=0.11, p=0.03) or inflammation (CRP: ρ=0,35, p=0.02) biomarkers. However, variation of SQS between admission and 3 months exhibited promising predictive value for adverse cardiac events with an AUC of 97,5% (sensitivity =90, specificity =74%). This analysis showed that a reduction of SQS lower than 42% was a risk factor for cardiac event. Conclusion The follow up of LGE decrease with SQS at three months is a useful tool to predict cardiovascular events in the year following an acute viral myocarditis. The author hereby declares no conflict of interest
The author hereby declares no conflict of interest
0083 Hyperhemia on the first-pass MRI perfusion for the diagnosis of acute myocarditis Samuel Zarka *, Claire Bouleti, Dimitri Arangalage, Houzefa Chopra, Guillaume Baudry, Philippe-Gabriel Steg, Alec Vahanian, Jean-Pierre Laissy, Phalla Ou APHP-Hôpital Bichat-Claude Bernard, Paris, France * Corresponding author: [email protected] (Samuel Zarka) Background MRI is the current way for the diagnosis of acute myocarditis, based on the Lake Louise criteria (presence of at least two of the three following criteria: myocardial edema, hyperaemia and/or a late Gadolinium enhancement). The first-pass perfusion sequence, used for detecting myocardial ischemia, may also be used to highlight a myocardial hyperemia in acute myocarditis. Purpose The aim of our study was to assess subepicardial hyperemia, seen on the first pass perfusion sequence by MRI, as a new method for the diagnosis of acute myocarditis.
Abstract 0094 – Figure: Example of Epicardial Adipose tissue assessment
0486 Predictive value of late gadolinium enhancement quantification with cardiac magnetic resonance imaging in acute myocarditis Heloise Prigent Manchon * (1), Nicolas Vodovar (2), Philippe Soyer (1), Alain Cohen Solal (1), Marc Sirol (1) (1) APHP-Hôpital Lariboisière, Paris, France – (2) Université ParisDiderot, INSERM 942, Paris, France * Corresponding author: [email protected] (Heloise Prigent Manchon) Introduction Prognostic factors after acute myocarditis are lacking, yielding heterogeneity in follow-up practices. We hypothesized that quantifying the late gadolinium enhancement (LGE) during cardiac magnetic resonance imaging (CMRI) could be an appealing tool to predict the risk of cardiovascular event. Objective This pilot study aimed at evaluating the variation in LGE SemiQuantitative Score (SQS) between CMRI at admission and a second CMRI three months later, as a predictive tool of adverse cardiac events following an acute viral myocarditis. Method 49 patients with acute viral myocarditis as confirmed by CMRI Lake Louise criteria were included. Patients had a second CMRI at 3 months and were followed clinically during one year. No cardiovascular event occurred between discharge and the second CMRI at three months. LGE was quantified at M0 and M3, using SQS already validated in ischemic cardiomyopathy. SQS predictive value was assessed in the acute phase and at one year using a combination of death from cardiovascular cause, heart failure or severe arrhythmias as main outcome. Results In most cases (n=39, 79,5 %), LGE decreased over the time after an acute myocarditis and rarely disappeared (n=5, 10%). At admission, we did
Method 47 patients (mean age = 42.4±15,6 years; 35 men) with acute myocarditis were included and compared to 16 healthy controls (without heart disease). The first-pass perfusion was evaluated by two blinded observers and compared to myocardial late Gadolinium enhancement, considered the reference method for the diagnosis of acute myocarditis, using both a qualitative (visual analysis) and a semi-quantitative method (ratio of the signals: infarction hyperaemia / healthy myocardium). Results 24 (51.1 %) patients with myocarditis exhibited detectable hyperemia. Qualitative analysis showed good inter-observer variability (kappa = 0.75). There was an increase of the signal intensity in the myocardium with hyperhemia as compared to the adjacent normal myocardium (myocarditis vs controls: 1.08±0.03 vs 0.95±0.05, p=0.03; myocarditis with hyperhemia vs myocarditis non hyperhemia: 1.22±0.04 vs 0.94 ±0.04, p<0.0001). The correlation between the first-pass perfusion and late Gadolinium enhancement was good (kappa = 0,70). Considering the late Gadolinium enhancement as gold standard, the calculated values of sensitivity and specificity were 85% and 94%, respectively. Conclusion Hyperhemia on the First-pass perfusion sequence, is a valuable and reproducible tool for the diagnosis of acute myocarditis. The author hereby declares no conflict of interest
0553 Assessment of myocardial deformation using multi-layer speckle tracking in patients undergoing chemotherapy: a comparison of two vendors Yann Ancedy (1), Stephane Ederhy * (1), Sylvie Lang (1), Antoine Hollebecque (2), Laurie Soulat-Dufour (1), Saroumadi Adavane-Scheuble (1), Marion Chauvet (1), Arnaud Etienney (1), Franck Boccara (1), JeanCharles Soria (2), Ariel Cohen (1) (1) APHP-Hôpital Saint-Antoine, Paris, France – (2) Centre régional de lutte contre le cancer Gustave-Roussy, Villejuif, France * Corresponding author: [email protected] (Stephane Ederhy) Background The purpose of this study was to investigate intervendor variability when measuring multilayer strain in cancer patients treated with oral chemotherapy.
© Elsevier Masson SAS. All rights reserved.