Jiang Luying, Zuo Houjuan, Liu Jingbo, Wang Jianyu, Zhang Kaiyue, Zhang Chunran, Peng Xiangyang, Liu Yujian, Wang Daowen, Li Haojie, Wang Hong
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders, Wuhan, China.
Front Cardiovasc Med. 2023 Jun 27;10:1144469. doi: 10.3389/fcvm.2023.1144469. eCollection 2023.
Myocardial fibrosis, as quantified by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR), provides valuable prognostic information for patients with myocarditis. However, due to the low incidence rate of fulminant myocarditis (FM) and accordingly small sample size, the knowledge about the role of LGE to patients with FM is limited.
A total of 44 adults with viral-FM receiving the Chinese treating regimen were included in this retrospective study. They were divided into the low LGE group and the high LGE group according to the ratio of LGE to left ventricular mass (LGE mass%). CMR exams and LGE were performed after hemodynamic assistance at discharge in all patients with FM. Routine echocardiography parameters and global longitudinal strain (GLS) at discharge and at 2-year follow-up were obtained and then compared. Both left ventricular ejection fraction (LVEF) and GLS showed no significant difference in both groups at discharge, whereas significant differences were observed at 2-year follow-up between two groups. Moreover, there were significant improvements of LVEF and GLS in the low LGE group, but not in the high LGE group during the 2-year period. Furthermore, LGE mass% was negatively correlated with GLS and LVEF.
There were two distinct forms of LGE presentation in patients with FM. Moreover, the cardiac function of patients with low LGE was significantly better than those with high LGE at 2-year follow-up. LGE mass% at discharge provided significant prognosis information about cardiac function of patients with FM.
通过心脏磁共振成像（CMR）中的延迟钆增强（LGE）量化的心肌纤维化，为心肌炎患者提供了有价值的预后信息。然而，由于暴发性心肌炎（FM）的发病率较低，样本量相应较小，关于LGE对FM患者作用的了解有限。
本回顾性研究纳入了44例接受中医治疗方案的成人病毒性FM患者。根据LGE与左心室质量的比值（LGE质量%）将他们分为低LGE组和高LGE组。所有FM患者在出院时接受血流动力学支持后进行CMR检查和LGE检查。获取出院时和2年随访时的常规超声心动图参数和整体纵向应变（GLS），然后进行比较。两组患者出院时左心室射血分数（LVEF）和GLS均无显著差异，而在2年随访时两组间观察到显著差异。此外，在2年期间，低LGE组的LVEF和GLS有显著改善，而高LGE组则没有。此外，LGE质量%与GLS和LVEF呈负相关。
FM患者存在两种不同形式的LGE表现。此外，在2年随访时，低LGE患者的心脏功能明显优于高LGE患者。出院时的LGE质量%为FM患者的心脏功能提供了重要的预后信息。
