Department of Cardiology, Amiens University Hospital, 80000, Amiens, France.
UR UPJV 7517, Jules Verne University of Picardie, 80000 Amiens, France.
Eur Heart J Cardiovasc Imaging. 2024 Jun 28;25(7):892-900. doi: 10.1093/ehjci/jeae092.
To assess the current role of cardiac imaging in the diagnosis, management, and follow-up of patients with acute myocarditis (AM) through a European Association of Cardiovascular Imaging survey.
A total of 412 volunteers from 74 countries responded to the survey. Most participants worked in tertiary centres (56%). All participants had access to echocardiography, while 79 and 75% had access to cardiac computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR), respectively. Less than half (47%) had access to myocardial biopsy, and only 5% used this test routinely. CMR was performed within 7 days of presentation in 73% of cases. Non-ischaemic late gadolinium enhancement (LGE, 88%) and high-signal intensity in T2-weighted images (74%) were the most used diagnostic criteria for AM. CCTA was preferred to coronary angiography by 47% of participants to exclude coronary artery disease. Systematic prescription of beta-blockers and angiotensin-converting enzyme inhibitors was reported by 38 and 32% of participants. Around a quarter of participants declared considering LGE burden as a reason to treat. Most participants (90%) reported performing a follow-up echocardiogram, while 63% scheduled a follow-up CMR. The main reason for treatment discontinuation was improvement of left ventricular ejection fraction (89%), followed by LGE regression (60%). In two-thirds of participants, the decision to resume high-intensity sport was influenced by residual LGE.
This survey confirms the high utilization of cardiac imaging in AM but reveals major differences in how cardiac imaging is used and how the condition is managed between centres, underlining the need for recommendation statements in this topic.
通过欧洲心血管影像协会的一项调查，评估心脏影像学在急性心肌炎（AM）患者的诊断、治疗和随访中的当前作用。
共有来自 74 个国家的 412 名志愿者对该调查做出了回应。大多数参与者工作在三级中心（56%）。所有参与者都可以进行超声心动图检查，而 79%和 75%的参与者分别可以进行心脏计算机断层扫描血管造影（CCTA）和心脏磁共振（CMR）检查。不到一半（47%）的参与者可以进行心肌活检，且仅有 5%的参与者常规使用该检查。73%的病例在发病后 7 天内进行 CMR 检查。非缺血性晚期钆增强（LGE，88%）和 T2 加权图像上的高信号强度（74%）是 AM 最常用的诊断标准。47%的参与者更倾向于使用 CCTA 排除冠状动脉疾病，而不是冠状动脉造影。38%和 32%的参与者报告常规开具β受体阻滞剂和血管紧张素转换酶抑制剂。约四分之一的参与者表示会考虑 LGE 负荷作为治疗的原因。大多数参与者（90%）报告进行了随访超声心动图检查，而 63%的参与者安排了随访 CMR 检查。停止治疗的主要原因是左心室射血分数改善（89%），其次是 LGE 消退（60%）。在三分之二的参与者中，决定恢复高强度运动的因素是残留 LGE。
这项调查证实了心脏影像学在 AM 中的广泛应用，但也揭示了不同中心在心脏影像学的使用和疾病管理方面存在的重大差异，这凸显了在该主题中制定推荐声明的必要性。
