Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis
dc.contributor.author | Gräni, Christoph | |
dc.contributor.author | Eichhorn, Christian | |
dc.contributor.author | Bière, Loïc | |
dc.contributor.author | Kaneko, Kyoichi | |
dc.contributor.author | Murthy, Venkatesh L | |
dc.contributor.author | Agarwal, Vikram | |
dc.contributor.author | Aghayev, Ayaz | |
dc.contributor.author | Steigner, Michael | |
dc.contributor.author | Blankstein, Ron | |
dc.contributor.author | Jerosch-Herold, Michael | |
dc.contributor.author | Kwong, Raymond Y | |
dc.date.accessioned | 2019-03-03T04:14:27Z | |
dc.date.available | 2019-03-03T04:14:27Z | |
dc.date.issued | 2019-02-28 | |
dc.identifier.citation | Journal of Cardiovascular Magnetic Resonance. 2019 Feb 28;21(1):14 | |
dc.identifier.uri | https://doi.org/10.1186/s12968-019-0520-0 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/148145 | |
dc.description.abstract | Abstract Background Although the presence of late gadolinium enhancement (LGE) using cardiovascular magnetic resonance imaging (CMR) is a significant discriminator of events in patients with suspected myocarditis, no data are available on the optimal LGE quantification method. Methods Six hundred seventy consecutive patients (48 ± 16 years, 59% male) with suspected myocarditis were enrolled between 2002 and 2015. We performed LGE quantitation using seven different signal intensity thresholding methods based either on 2, 3, 4, 5, 6, 7 standard deviations (SD) above remote myocardium or full width at half maximum (FWHM). In addition, a LGE visual presence score (LGE-VPS) (LGE present/absent in each segment) was assessed. For each of these methods, the strength of association of LGE results with major adverse cardiac events (MACE) was determined. Inter-and intra-rater variability using intraclass-correlation coefficient (ICC) was performed for all methods. Results Ninety-eight (15%) patients experienced a MACE at a medium follow-up of 4.7 years. LGE quantification by FWHM, 2- and 3-SD demonstrated univariable association with MACE (hazard ratio [HR] 1.05, 95% confidence interval [CI]:1.02–1.08, p = 0.001; HR 1.02, 95%CI:1.00–1.04; p = 0.001; HR 1.02, 95%CI: 1.00–1.05, p = 0.035, respectively), whereas 4-SD through 7-SD methods did not reach significant association. LGE-VPS also demonstrated association with MACE (HR 1.09, 95%CI: 1.04–1.15, p < 0.001). In the multivariable model, FWHM, 2-SD methods, and LGE-VPS each demonstrated significant association with MACE adjusted to age, sex, BMI and LVEF (adjusted HR of 1.04, 1.02, and 1.07; p = 0.009, p = 0.035; and p = 0.005, respectively). In these, FWHM and LGE-VPS had the highest degrees of inter and intra-rater reproducibility based on their high ICC values. Conclusions FWHM is the optimal semi-automated quantification method in risk-stratifying patients with suspected myocarditis, demonstrating the strongest association with MACE and the highest technical consistency. Visual LGE scoring is a reliable alternative method and is associated with a comparable association with MACE and reproducibility in these patients. Trial registration number NCT03470571 . Registered 13th March 2018. Retrospectively registered. | |
dc.title | Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis | |
dc.type | Article | en_US |
dc.description.bitstreamurl | https://deepblue.lib.umich.edu/bitstream/2027.42/148145/1/12968_2019_Article_520.pdf | |
dc.language.rfc3066 | en | |
dc.rights.holder | The Author(s). | |
dc.date.updated | 2019-03-03T04:14:28Z | |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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