Background
Methods
Study population
CMR protocol
Image analysis
Statistical analysis
Results
Clinical characteristics
Healthy Control Group (n = 30) | Myocarditis Group (n = 50) | p Value | |
---|---|---|---|
Age (y) | 36.9 ± 13.5 | 38 ± 16.3 | 0.764 |
Male (%) | 23 (77) | 37 (74) | 0.505 |
BMI (kg/m2) | 25.3 ± 4.1 | 25.4 ± 5.2 | 0.937 |
CMR results | |||
Symptom onset to CMR (d) | – | 2.9 ± 1.8 | – |
Heart rate (bpm) | 68.1 ± 12.4 | 74.1 ± 15.2 | 0.170 |
LVEF (%) | 61.6 ± 4.6 | 55.3 ± 9.4 | 0.004 |
LVEDV/BSA (ml/m2) | 74.3 ± 9.4 | 78.1 ± 17.1 | 0.552 |
IVST (mm) | 9.5 ± 1.6 | 9.8 ± 1.7 | .311 |
Blood values | |||
Max. Trop I (ng/ml) | – | 18.9 ± 78.2 | – |
Leucocytes (103/μmL) | 6.5 ± 1.7 | 10.4 ± 4.7 | 0.001 |
C-reactive protein (mg/L) | 1.0 ± .8 | 70.7 ± 99 | <0.001 |
CK-MB mass | – | 21.4 ± 36.6 | – |
Creatine kinase (U/L) | – | 363.5 ± 489.8 | – |
Haematocrit (%) | 41.7 ± 3.9 | 40.5 ± 5.6 | 0.304 |
Number of patients with myocarditis specific parameters (%) | |||
Fulfilling the LLC (%) | 0 (0) | 36 (72) | <0.001 |
T2 ratio/visible edema (%) | 2 (7) | 33 (66) | <0.001 |
EGEr/aME (%) | 6 (20) | 24 (59) | 0.001 |
LGE (%) | 0 (0) | 39 (78) | <0.001 |
Myocarditis specific parameters | |||
T2 SI myocardium | 763.5 ± 268.9 | 893.4 ± 262.7 | 0.004 |
T2 SI skeletal muscle | 472.5 ± 157.3 | 465 ± 132.8 | 0.826 |
T2 ratio | 1.6 ± 0.3 | 1.9 ± 0.4 | <0.001 |
EGEr | 2.3 ± 1.9 | 3.1 ± 1.8 | 0.063 |
aMe (%) | 37.5 ± 18.3 | 54.4 ± 31.6 | 0.007 |
LGE in % | 0 | 12,1 ± 11.8 | – |
CMR characteristics
Measurement results
Control group | Myocarditis group | pValue | |
---|---|---|---|
Native T1 (ms) | |||
Global | 958.9 ± 22.5 | 1027.2 ± 49.3 | <0.001 |
mSAX | 954.3 ± 28.6 | 1023.4 ± 29.9 | <0.001 |
ConSept | 969.7 ± 28.6 | 1022.8 ± 60.8 | <0.001 |
Remote | 958.9 ± 22.5 | 1014.3 ± 54.7 | <0.001 |
ECV (%) | |||
Global | 27.7 ± 3.2 | 32 ± 6.4 | 0.010 |
mSAX | 26.6 ± 3.5 | 31.4 ± 7.2 | 0.005 |
ConSept | 27.7 ± 4.2 | 31 ± 7.2 | 0.043 |
Remote | 27.7 ± 3.2 | 31.9 ± 7.1 | 0.027 |
T2 (ms) | |||
Global | 51.6 ± 1.9 | 58 ± 6 | <0.001 |
mSAX | 51.4 ± 3.2 | 58.4 ± 7 | <0.001 |
ConSept | 51.2 ± 3.9 | 58.2 ± 7.4 | <0.001 |
Remote | 51.6 ± 1.9 | 56.4 ± 6.1 | <0.001 |
Cut off | AUC | Sensitivity (%) | Specifity (%) | PPV (%) | NPV (%) | Accuracy (%) | |
---|---|---|---|---|---|---|---|
Native T1 (ms) | |||||||
Global | > 980 | 0.903 | 85 | 90 | 93 | 79 | 87 |
mSAX | > 985 | 0.850 | 76 | 93 | 95 | 72 | 83 |
ConSept | > 999 | 0.783 | 65 | 97 | 97 | 62 | 77 |
Remote | > 980 | 0.841 | 73 | 90 | 91 | 69 | 80 |
ECV (%) | |||||||
Global | > 31 | 0.731 | 47 | 88 | 87 | 49 | 62 |
mSAX | > 28 | 0.717 | 67 | 72 | 81 | 56 | 69 |
ConSept | > 27 | 0.633 | 70 | 52 | 71 | 50 | 63 |
Remote | > 29 | 0.685 | 64 | 68 | 76 | 55 | 66 |
T2 (ms) | |||||||
Global | > 54 | 0.847 | 80 | 87 | 90 | 74 | 82 |
mSAX | > 53 | 0.831 | 78 | 87 | 90 | 72 | 81 |
ConSept | > 53 | 0.820 | 80 | 87 | 90 | 74 | 82 |
Remote | > 54 | 0.799 | 74 | 87 | 89 | 70 | 79 |
Intra-observer agreement | Inter-observer agreement | |||||
---|---|---|---|---|---|---|
Δm (ms) | 95% CI (ms) | Pearson’s r | Δm (ms) | 95% CI (ms) | Pearson’s r | |
Native T1 | ||||||
Global | 4.9 | [−8.2;18.1] | .99 | 3.2 | [−14.6;20.9] | .98 |
mSAX | 8.1 | [−23;39.3] | .96 | 0.9 | [−33.5;35.4] | .96 |
ConSept | 11.8 | [− 46.9;70.6] | .85 | 17 | [−46.8;80.8] | .83 |
Remote | 4.2 | [−9.9;18.3] | .99 | 5.6 | [− 34.8;46] | .88 |
ECV | ||||||
Global | 0.6 | [−3.8;5.1] | .96 | 0.5 | [−3;4] | .98 |
mSAX | 2.1 | [−6.4;10.6] | .87 | 1.8 | [−5.6;9.2] | .90 |
ConSept | 2 | [−5.7;9.8] | .89 | 1.4 | [−5.6;8.4] | .92 |
Remote | 0.5 | [−2.9;3.8] | .98 | 0.6 | [−1.9;3.2] | .99 |
T2 | ||||||
Global | 0.5 | [−2;3] | .97 | 0.3 | [−3;3.5] | .97 |
mSAX | 0.7 | [−7;8.3] | .88 | −0.2 | [−7.1;6.7] | .94 |
ConSept | 2.2 | [−3.9;8.2] | .92 | 3.1 | [−7.4;13.6] | .73 |
Remote | 0.7 | [−1.4;2.7] | .99 | 0.5 | [−2.9;3.8] | .97 |