title: Long-term follow-up of patients paragraph sign with acute myocarditis by magnetic paragraph sign resonance imaging.
abstract: Magnetic resonance imaging (MRI) reveals cardiac signal intensity changes in patients with acute myocarditis; however, the natural history of these changes and their relationship to individual outcomes are unknown. The relationship of MRI findings to long-term outcome was studied by serial MRI studies in 16 patients with acute myocarditis who were followed for 30+/-4 (SE) months. Myocardial contrast enhancement was monitored using contrast-enhanced T1-weighted fast spin-echo images. Left ventricular ejection fraction was measured with gradient-echo sequences. Clinical symptoms were scored. The results were compared to a control group of 26 age-matched, healthy volunteers. Myocardial contrast enhancement, which was markedly increased in the early course of the disease, decreased at 4 weeks and remained within the normal range in most patients after 30 months. Contrast enhancement 4 weeks after onset of symptoms was predictive for the functional and clinical long-term outcome.Contrast-enhanced MRI may be a useful, noninvasive tool for longterm follow-up of patients with acute myocarditis. Furthermore, relatively early MRI findings may predict longer-term outcomes.
authors.affiliation: Franz-Volhard-Klinik, Working group 'Cardiac Magnetic Resonance', Charité Campus Buch, Humboldt University, Wiltbergstrasse 50, 13122 Berlin, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Wagner
authors.forename: Jeanette
authors.initials: J
authors.lastname: Schulz-Menger
authors.forename: Rainer
authors.initials: R
authors.lastname: Dietz
authors.forename: Matthias G
authors.initials: MG
authors.lastname: Friedrich
mesh_terms: D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors