Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554, Monserrato, 09045, Cagliari, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Eur Radiol. 2024 Sep;34(9):5724-5735. doi: 10.1007/s00330-024-10677-9. Epub 2024 Mar 11.
Our study aimed to explore with cardiovascular magnetic resonance (CMR) the impact of left atrial (LA) and left ventricular (LV) myocardial strain in patients with acute pericarditis and to investigate their possible prognostic significance in adverse outcomes.
This retrospective study performed CMR scans in 36 consecutive patients with acute pericarditis (24 males, age 52 [23-52]). The primary endpoint was the combination of recurrent pericarditis, constrictive pericarditis, and surgery for pericardial diseases defined as pericardial events. Atrial and ventricular strain function were performed on conventional cine SSFP sequences.
After a median follow-up time of 16 months (interquartile range [13-24]), 12 patients with acute pericarditis reached the primary endpoint. In multivariable Cox regression analysis, LA reservoir and LA conduit strain parameters were all independent determinants of adverse pericardial diseases. Conversely, LV myocardial strain parameters did not remain an independent predictor of outcome. With receiving operating characteristics curve analysis, LA conduit and reservoir strain showed excellent predictive performance (area under the curve of 0.914 and 0.895, respectively) for outcome prediction at 12 months.
LA reservoir and conduit mechanisms on CMR are independently associated with a higher risk of adverse pericardial events. Including atrial strain parameters in the management of acute pericarditis may improve risk stratification.
Atrial strain could be a suitable non-invasive and non-contrast cardiovascular magnetic resonance parameter for predicting adverse pericardial complications in patients with acute pericarditis.
• Myocardial strain is a well-validated CMR parameter for risk stratification in cardiovascular diseases. • LA reservoir and conduit functions are significantly associated with adverse pericardial events. • Atrial strain may serve as an additional non-contrast CMR parameter for stratifying patients with acute pericarditis.
本研究旨在利用心血管磁共振（CMR）探讨急性心包炎患者左心房（LA）和左心室（LV）心肌应变的影响，并研究其在心包不良预后中的可能预测意义。
这项回顾性研究对 36 例连续的急性心包炎患者（24 名男性，年龄 52[23-52]岁）进行了 CMR 扫描。主要终点是复发性心包炎、缩窄性心包炎和心包疾病手术的联合定义为心包事件。在常规电影 SSFP 序列上进行心房和心室应变功能检查。
在中位数为 16 个月（四分位间距 [13-24]）的随访后，12 例急性心包炎患者达到了主要终点。在多变量 Cox 回归分析中，LA 储备和 LA 输送应变参数均为不良心包疾病的独立决定因素。相反，LV 心肌应变参数不是结局的独立预测因子。接受者操作特征曲线分析显示，LA 输送和储备应变在 12 个月时对结局预测具有优异的预测性能（曲线下面积分别为 0.914 和 0.895）。
CMR 上的 LA 储备和输送机制与不良心包事件的风险增加独立相关。在急性心包炎的管理中纳入心房应变参数可能会改善风险分层。
心房应变可能是预测急性心包炎患者不良心包并发症的一种合适的非侵入性和非对比心血管磁共振参数。
•心肌应变是心血管疾病风险分层的一种经过充分验证的 CMR 参数。•LA 储备和输送功能与不良心包事件显著相关。•心房应变可作为急性心包炎患者分层的附加非对比 CMR 参数。
