title: Myocardial inflammation on cardiovascular magnetic resonance predicts left ventricular function recovery in children with recent dilated cardiomyopathy.
abstract: OBJECTIVE
  To analyse the predictive role of myocardial inflammation assessed by cardiac magnetic resonance (CMR) on the outcome of recently diagnosed dilated cardiomyopathy in children.
  
  
  RESULTS
  Over a period of 4 years, 66 children underwent CMR within 2 weeks after the diagnosis of dilated cardiomyopathy. CMR sequences sensitive for oedema, hyperaemia, and irreversible injury were applied: unenhanced cine steady-state free precession (SSFP), black-blood-prepared T1-weighted images, T2-weighted images, gadolinium-enhanced T1-weighted images (EGE), and late gadolinium-enhanced (LGE) images. Inflammatory cardiomyopathy defined as the presence of at least two CMR criteria was diagnosed in 31/66 children (CMR positive) while no criterion was present in the remaining 33 (CMR-negative). Only two patients had one positive criterion and were excluded from subsequent analysis. After a mean follow-up of 24 months, LV function recovery (LV ejection fraction >55%) was more frequent in the CMR-positive group (24 vs. 11, P < 0.05). The presence of myocardial inflammation and elevated troponin levels at baseline were the two predictors of LV function recovery with an odds ratio of 3.76 (P = 0.02) and 2.76 (P = 0.03), respectively, in a logistic regression model. Persisting LGE was rare in patients of the CMR-positive group at control CMR (6/22) and was never observed in the CMR-negative group (0/16).
  
  
  CONCLUSIONS
  The presence of myocardial inflammation on CMR at time of diagnosis of a dilated cardiomyopathy in children is a strong predictor of LV recovery.
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Francesca
authors.initials: F
authors.lastname: Raimondi
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Iserin
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Raisky
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Daniela
authors.initials: D
authors.lastname: Laux
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Bajolle
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: Younes
authors.initials: Y
authors.lastname: Boudjemline
authors.affiliation: Radiology Department, Université Paris Descartes, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.affiliation: Centre de Référence Malformations Cardiaques Congénitales Complexes-M3C, Université Paris Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France damien.bonnet@nck.aphp.fr damien.bonnet1@gmail.com.
authors.forename: Damien
authors.initials: D
authors.lastname: Bonnet
mesh_terms: D000293:Adolescent; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D016015:Logistic Models; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D019786:Gadolinium DTPA
keywords: cardiac magnetic resonance imaging; children; heart failure; inflammatory cardiomyopathy; myocarditis