title: Clinical and magnetic resonance evolution of "infarct-like" myocarditis.
abstract: OBJECTIVE
  To analyse the clinical and magnetic resonance evolution of myocarditis in patients with an "infarct-like" presentation pattern.
  
  
  METHODS
  The study is a retrospective analysis of 52 patients with clinical diagnosis of "infarct-like" myocarditis confirmed by CMR as acute myocarditis according to Lake Louise criteria and 6 months follow-up. The CMR protocol included T2-weighted (oedema), early (hyperaemia) and late (fibrosis/necrosis) gadolinium enhancement sequences, according to Lake Louise criteria. Clinical and radiological follow-up by CMR was performed after a median time interval of 6 months (interquartile range 5-8). Quantitative outcomes were checked for normality and compared with the non-parametric Wilcoxon's test for matched data.
  
  
  RESULTS
  At the clinical follow-up all patients were free of symptoms and reported no cardiac complications. The CMR follow-up evidenced a significant increase of the ejection fraction (from 53 ± 6 to 55 ± 4%, p = 0.03), a decrease of the ventricular mass [from 67.0 (58.8-79.0) to 61.0 (54.0-67.0), p < 0.0001] without significant modification of the cardiac volume index (p = 0.26). No patient had residual oedema or capillary leakage: the T2 ratio decreased from 3.94 (3.00-4.86) to 0.98 (0.75-1.17) with p < 0.0001 and the Early gadolinium enhancement (EGE) ratio from 5.7 (4.8-6.5) to 2.9 (2.4-3.2) with p < 0.0001. Late gadolinium enhancement (LGE) persisted over the course of the follow-up in 48/52 patients, but with a significant reduction in every patient (LGE % from 34.3 ± 9.1 to 19.4 ± 6.6%; p < 0.0001).
  
  
  CONCLUSIONS
  Patients diagnosed with "infarct-like" myocarditis, according to both clinical and CMR examinations may look forward to a positive evolution with a good prognosis.
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Faletti
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy. marcogatti17@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Gatti
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Baralis
authors.affiliation: Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bergamasco
authors.affiliation: Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Bonamini
authors.affiliation: Division of Pediatric Cardiology, Citta' della Salute e della Scienza, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferroni
authors.affiliation: University Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Torino, Turin, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imazio
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stola
authors.affiliation: University Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Torino, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Department of Surgical Sciences, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
mesh_terms: D000328:Adult; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009205:Myocarditis / Q000000981:diagnostic imaging*; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: Acute myocarditis; Cardiovascular magnetic resonance; Outcome; “Infarct-like” myocarditis