title: Electrocardiographic findings and myocardial damage in acute myocarditis detected by cardiac magnetic resonance.
abstract: Delayed-contrast-enhancement (DCE) magnetic resonance imaging (MRI) can identify areas of myocardial damage in patients with acute myocarditis (AM). The aim of this study was to assess the electrocardiographic findings in AM diagnosed by DCE-MRI. Eighty-one patients (72 men, 35 ± 13 years) with AM were prospectively enrolled. All of them underwent MRI and 12-lead-ECG recordings. In the admission electrocardiogram (ECG 1), as well as in that obtained 48 h later (ECG 2), the following parameters were analyzed: rhythm, PR, QRS, and QTc-intervals, intraventricular conduction, abnormal Q waves, ST segment elevation, and T wave inversion. On admission, 77 patients (95%) were in sinus rhythm, while four patients (6%) manifested severe arrhythmias. No difference between ECG 1 and ECG 2 was observed regarding abnormal Q waves, PR, QRS, and QTc-intervals. Electrocardiogram 1 was normal in 26 patients (32%, normal ECG group), and abnormal in 55 patients (68%, abnormal ECG group). ST elevation was found in 46 patients (57%), inverted T wave in seven patients (9%) and left bundle branch block (LBBB) in two patients (3%). Areas of DCE suggesting AM were found in each patient. No relationship concerning the location of the involved region (s) was found between ECG (leads with ST/T abnormalities) and MRI (areas showing DCE). The ECG in AM can either be normal or reflect abnormalities including arrhythmias, LBBB, ST segment elevation, and T wave inversion. The location of myocardial involvement deduced on the basis of ECG leads showing ST/T changes is not in close relationship with the areas of ventricular damage detected by MRI.
authors.affiliation: Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Via Consolare Valeria No. 1, 98100 Messina, Italy. gianluca.dibella@tiscali.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Anca
authors.initials: A
authors.lastname: Florian
authors.forename: Lilia
authors.initials: L
authors.lastname: Oreto
authors.forename: Carmela
authors.initials: C
authors.lastname: Napolitano
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Todaro
authors.forename: Rocco
authors.initials: R
authors.lastname: Donato
authors.forename: Sara
authors.initials: S
authors.lastname: Calamelli
authors.forename: Giovanni Salvatore
authors.initials: GS
authors.lastname: Camastra
authors.forename: Concetta
authors.initials: C
authors.lastname: Zito
authors.forename: Scipione
authors.initials: S
authors.lastname: Carerj
authors.forename: Jan
authors.initials: J
authors.lastname: Bogaert
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oreto
mesh_terms: D000208:Acute Disease; D000328:Adult; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D017682:Myocardial Stunning / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity