Introduction
Materials and methods
Study population
CMR protocol
LGE data analysis
Statistical analysis
Results
Baseline characteristics
n = 47 | |
---|---|
Baseline characteristics | |
Age (years), median [IQR] | 27 [21; 38] |
Male, n (%) | 38 (81) |
BMI (kg/m2), median [IQR] | 26 [23; 31] |
Cardiovascular risk factors | |
Hypertension, n (%) | 4 (9) |
Diabetes, n (%) | 2 (4) |
Hyperlipidemia, n (%) | 3 (6) |
Smoking history, n (%) | 22 (47) |
Active smoker, n (%) | 17 (36) |
Family risk of CAD, n (%) | 11 (23) |
Symptoms at presentation | |
Chest pain, n (%) | 40 (85) |
Dyspnea, n (%) | 8 (17) |
Palpitation, n (%) | 9 (19) |
Dizziness or syncope, n (%) | 5 (11) |
Fever, n (%) | 13 (27) |
Recent respiratory infection or flu, n (%) | 20 (43) |
Recent gastrointestinal infection, n (%) | 12 (25) |
Recent other infection, n (%) | 4 (4) |
Timing of examinations | |
Admission to baseline CMR (days), median [IQR] | 2 (1–3) |
Baseline to follow-up CMR (days), median [IQR] | 92 [83; 103] |
n = 47 | Baseline | Follow-up | p value | |
---|---|---|---|---|
Laboratory parameter | ||||
CRP (mg/mL), median [IQR] | 23 [6; 60] | 1.2 [0.6; 2] | < 0.01 | |
CK (U/L), median [IQR] | 219 [98; 426] | 114 [88; 158] | < 0.01 | |
Hs-TnT (ng/L), median [IQR] | 300 [133; 843] | 5 [4; 8] | < 0.01 | |
Myoglobin (µg/L), median [IQR] | 35 [23; 75] | 30 [24; 39] | 0.02 | |
NT-proBNP (ng/L), median [IQR] | 176 [71; 635] | 25 [13; 40] | < 0.01 | |
ECG parameter | ||||
Nonsinus rhythm, n (%) | 1 (2) | 1 (2) | 1.00 | |
Ventricular extrasystole, n (%) | 3 (6) | 2 (4) | 1.00 | |
Atrioventricular-block, n (%) | 1 (2) | 1 (2) | 1.00 | |
Fascicular-block, n (%) | 2 (4) | 5 (11) | 0.08 | |
> 0.5 mm PQ depression, n (%) | 2 (4) | 1 (2) | 1.00 | |
> 1 mm ST-segment elevation, n (%) | 14 (30) | 2 (4) | < 0.01 | |
> 1 mm ST-segment depression, n (%) | 3 (6) | 1 (2) | 0.50 | |
T-inversion, n (%) | 17 (36) | 13 (28) | 0.45 | |
Pathological QRS-T angle (> 100o), n (%) | 4 (9) | 1 (2) | 0.50 | |
Wide QRS complex (>120 ms), n (%) | 2 (4) | 0 (0) | 0.50 | |
Prolonged QTc interval (> 420 ms), n (%) | 18 (38) | 8 (17) | 0.01 | |
CMR parameter | ||||
LVEDDi (mm/m2), median [IQR] | 27 [25; 29] | 27 [25; 28] | 0.26 | |
Septum thickness (mm), median [IQR] | 8 [8; 9] | 8 [8; 9] | 0.91 | |
Lateral wall thickness (mm), median [IQR] | 8 [7; 9] | 8 [7; 8] | 0.08 | |
LVEF (%), median [IQR] | 56 [54; 61] | 56 [55; 59] | 0.92 | |
LVEDVi (mL/m2), median [IQR] | 84 [73; 96] | 85 [73; 93] | 0.18 | |
LVESVi (mL/m2), median [IQR] | 36 [30; 43] | 37 [39; 40] | 0.58 | |
LV mass index (g/m2), median [IQR] | 57 [49; 69] | 50 [44; 58] | < 0.01 | |
RVEF (%), median [IQR] | 59 [55; 63] | 59 [57; 63] | 0.99 | |
RVEDVi (mL/m2), median [IQR] | 81 [70; 91] | 80 [66; 87] | 0.56 | |
RVESVi (mL/m2), median [IQR] | 33 [28; 39] | 32 [24; 39] | 0.58 |
LGE findings between baseline and at follow-up
n = 47 | Baseline LGE amount | Follow-up LGE amount | LGE extent change | Patients with LGE progression | Patients with LGE regression |
---|---|---|---|---|---|
Quantitative | |||||
FWHM, median [IQR] or n (%) | 3.7 [1.6; 6.5] | 1.8 [0.7; 2.5] | −1.8 [−3.8; 0] | 3 (6) | 26 (55) |
SD5, median [IQR] or n (%) | 4.0 [1.8; 8.8] | 2.1 [0.9; 3.8] | −2.4 [−7.2; −0.1] | 7 (15) | 28 (60) |
SD6, median [IQR] or n (%) | 2.7 [0.8; 6.8] | 1.0 [0.4; 2.2] | −1.6 [−5.2; 0] | 4 (9) | 27 (57) |
VAT, median [IQR] or n (%) | 2.0 [0.7; 4.6] | 1.5 [0.7; 2.4] | −0.3 [−2.1; 0.3] | 4 (9) | 16 (34) |
FM, median [IQR] or n (%) | 3.0 [1.4; 6.2] | 1.6 [0.3; 2.4] | −1.2 [−3.8; −0.5] | 2 (4) | 26 (55) |
Semiquantitative | |||||
VPS, median [IQR] or n (%) | 2 [1; 4] | 1 [1; 2] | −1 [−1; 0] | 0 (0) | 25 (53) |
VTS, median [IQR] or n (%) | 5 [2; 9] | 2 [1; 4] | −2 [−4; −1] | 0 (0) | 36 (77) |
VCS, median [IQR] or n (%) | −3 [−4; −2] | 0 (0) | 42 (89) |
Repeatability of LGE assessment
n = 47 | Baseline | Follow-up | LGE change |
---|---|---|---|
ICC quantitative | |||
FWHM, median [IQR] | 0.98 [0.96; 0.99] | 0.98 [0.97; 0.98] | 0.97 [0.94; 0.98] |
SD5, median [IQR] | 0.94 [0.90; 0.96] | 0.79 [0.65; 0.87] | 0.89 [0.81; 0.93] |
SD6, median [IQR] | 0.93 [0.89; 0.96] | 0.78 [0.64; 0.87] | 0.91 [0.86; 0.95] |
VAT, median[IQR] | 0.94 [0.89; 0.96] | 0.95 [0.91; 0.97] | 0.92 [0.87; 0.95] |
FM, median [IQR] | 0.95 [0.91; 0.97] | 0.91 [0.86; 0.95] | 0.92 [0.87; 0.95] |
ICC semiquantitative | |||
VPS, median [IQR] | 0.80 [0.59; 0.89] | 0.66 [0.39; 0.81] | 0.81 [0.63; 0.90] |
VTS, median [IQR] | 0.77 [0.52; 0.89] | 0.89 [0.56; 0.90] | 0.71 [0.53; 0.83] |
CS, median [IQR] | 0.93 [0.89; 0.96] |
Association between different LGE assessment techniques
VPS | VTS | VCS | |||||||
---|---|---|---|---|---|---|---|---|---|
ρ | p value | ρ | p value | ρ | p value | ||||
FWHM | 0.31 | 0.03 | 0.40 | 0.01 | 0.26 | 0.08 | |||
SD5 | 0.44 | < 0.01 | 0.62 | < 0.01 | 0.25 | 0.07 | |||
SD6 | 0.45 | < 0.01 | 0.60 | < 0.01 | 0.27 | 0.07 | |||
VAT | 0.45 | < 0.01 | 0.56 | < 0.01 | 0.35 | 0.02 | |||
FM | 0.47 | < 0.01 | 0.73 | < 0.01 | 0.38 | 0.01 | |||
VPS | – | – | – | – | 0.68 | < 0.01 | |||
VTS | – | – | – | – | 0.60 | < 0.01 |
Discussion
Acknowledgements
Funding
Compliance with ethical standards
Guarantor
Conflict of interest
Statistics and biometry
Informed consent
Ethical approval
Study subjects or cohorts overlap
Methodology
-
Retrospective
-
Observational
-
Performed at one institution