Application of cardiac magnetic resonance T1 and T2 map-ping techniques in the diagnosis of acute myocarditis and the predictive value for major adverse cardiovascular events

LIU Jiao

摘要：Background Acute myocarditis is a disease characterized by inflammation of the heart muscle,usually caused by viral infection,autoimmune reactions,or toxins,resulting in damage and dysfunction of cardiomyocytes.In re-cent years,the incidence of acute myocarditis has gradually increased,especially in young people and athletes,which can cause serious cardiac complications and even lead to heart failure,cardiac arrest or major adverse cardio-vascular events(MACEs).Methods A total of 90 patients with acute myocarditis(acute myocarditis group)and 30 healthy subjects(control group)admitted to our hospital from November 2021 to November 2023 were selected.Cardiac magnetic resonance(CMR)T1 and T2 mapping sequence scanning and cardiac function parameter mea-surement was performed on all subjects.The acute myocarditis group was followed up for 12 months and divided into the MACEs group and the non-MACEs group according to whether MACEs occurred.The differences in CMR parameters were analyzed,and receiver operating characteristic(ROC)curve was applied to analyze the predictive value of cardiac CMR T1 and T2 techniques for the occurrence of MACEs in patients with acute myocarditis.Re-sults Compared with the control group,the level of left ventricular ejection fraction(LVEF)in the acute myocar-ditis group was significantly decreased,while left ventricular end-diastole volume(LVEDV),left ventricular end-systolic volume(LVESV),lactate dehydrogenase(LDH)and creatine kinase MB isoenzyme(CK-MB)increased significantly(P＜0.05);T1 and T2 values,late gadolinium enhancement(LGE)percentage of left ventricle,left ven-tricular entropy and extracellular volume(ECV)in acute myocarditis group were significantly higher than those in the control group(P＜0.05).Pearson correlation analysis showed that T1 and T2 values were negatively correlated with LVEF,while T1 and T2 values were positively correlated with LVESV,CK-MB,left ventricular entropy and ECV in patients with acute myocarditis(P＜0.05).Among patients with acute myocarditis,the values of T1 and T2,left ventricular entropy and ECV in MACEs group were higher than those in non-MACEs group(P＜0.05).Further multivariate analysis also showed that T1 and T2 values had independent predictive capacity for MACEs in patients with acute myocarditis(P＜0.05).The maximum area under ROC curve was 0.894 and 0.912,and the sensitivity was 89.35％and 90.40％in patients with acute myocarditis predicted by T1 and T2 mapping.The specificity was 80.34％and 84.25％.Conclusions CMR T1 and T2 mapping techniques can effectively evaluate the cardiac func-tion status of patients with acute myocarditis,and provide an important reference for the prognosis assessment of acute myocarditis.[S Chin J Cardiol 2024;25(4):216-224]