| Objective:This study used cardiac magnetic resonance feature tracking technology to compare and analyze the differences of conventional cardiac function parameters and myocardial strain parameters between the patients with acute myocarditis and healthy controls,and to explore the diagnostic value of left ventricular myocardial strain parameters in patients with acute myocarditisMethods and Materials:The study collected 41 patients with clinically diagnosed acute myocarditis admitted to Sir Run Run Shaw Hospital(SRRSH)from January 2014 to December 2018 as a case group,and recruited 31 physical examination patients and healthy volunteers at the same time as a control group.All subjects underwent cardiac magnetic resonance(CMR)scans on the 1.5T or 3.0T magnetic resonance device and all CMR images were post-processed on the CVI42 software to obtain the left ventricular cardiac function parameters and myocardial strain parameters.The former includes left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic volume index(LVEDVI),left ventricular end-systolic volume(LVESV).),Left ventricular end-systolic volume index(LVESVI),stroke volume(SV),stroke volume index(SVI),and left ventricular ejection fraction(Left ventricular ejection fraction(LVEF);the latter includes global radial strain(GRS),global radial strain rate(GRSr),global circumferential strain(GCS),and overall Global circumferential strain rate(GCSr),global longitudinal strain(GLS),and global longitudinal strain rate(GLSr).Then we compared the differences of these parameters between the two groups and determined the diagnostic value of myocardial strain parameters in patients with acute myocarditis.he follow-up of all patients with acute myocarditis was completed in March 2019.Myocarditis patients was divided into two groups according to whether major adverse cardiac events(MACE)happened.The differences in cardiac function and strain parameters between the two myocarditis groups were analysed again.Results:The LVESV and LVESVI of patients with acute myocarditis were higher than those of the control group(LVESV:62.03±27.07 vs.45.13±12.32 mL,P=0.004;LVESVI:35.22±17.12 vs.26.73±7.62 mL/m2,P=0.044),LVEF was lower(57.00±14.70 vs.65.36±6.09%,P=0.023),but the average LVEF>50%;the acute myocarditis group had significantly lower GRS,GRSr,GCS,GCSr than control group(GRS:22.95±9.88 vs.33.87±13.95%,P<0.001;GRSr:1.26±1.67 vs.2.06±1.58/s,P=0.025;GCS:-15.01±4.32 vs.-18.96±3.30%,P<0.001,GCSr:-0.87±0.27 vs.-1.02±0.17/s,P=0.004),and there is no statistical difference between GLS and GLSr.By plotting the ROC curve,we found the diagnostic sensitivity and accuracy of GRS were the highest,respectively 70.70%and 73.60%,and the specificity of GCSr was the highest 93.50%.In the myocarditis group,3 patients suffered MACE.Their age,CMR examination interval,LVEDVI,and LVESVI were significantly higher than those without MACE,while SVI,LVEF,GCS,GCSr,GLS,and GLSr were significantly lower.Conclusion:(1)In patients with acute myocarditis,left ventricular systolic function is more susceptible to impairment compared with diastolic function,but the degree of damage is usually mild,so LVEF can still be retained in most patients.(2)The reduction of radial and circumferential myocardial strain parameters were much more serious than the longitudinal strain parameters in acute myocarditis patients.GRS,GRSr,GCS and GCSr can be used to diagnose acute myocarditis.Especially,the sensitivity and accuracy of GRS are the highest,and the specificity of GCSr is the highest.(3)When the diastolic function of patients with acute myocarditis is impaired,LVEF is significantly reduced,and longitudinal strain parameters are also reduced,the patients may have a poor prognosis and an increased risk of MACE. |
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