Cardiac Magnetic Resonance in Acute Myocarditis

Study Overview
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Brief Summary
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Cardiac magnetic resonance (MR) is an established noninvasive diagnostic tool for detection of acute myocarditis. Diagnosis of myocarditis at 1.5T is currently made with the help of the Lake Louise Criteria (two of three criteria have to be positive in order to establish the diagnosis). Although these criteria are accepted and widely used in clinical routine, several disadvantages exist. Newer parameters like myocardial T1 and T2 mapping, extracellular volume fraction (ECV) and myocardial strain analysis have the potential to complement or even replace some of the Lake Louise Criteria and further enhance the diagnostic performance of cardiac MR in patients suspected of having acute myocarditis. The aim of our study is to evaluate the diagnostic performance of a comprehensive cardiac MR protocol in patients with acute myocarditis.

Official Title
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Cardiac Magnetic Resonance in Acute Myocarditis

Conditions
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Myocarditis

Intervention / Treatment
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* Other: Cardiac magnetic resonance scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: No past medical history of cardiac disease. No cardiovascular risk factors (e.g. diabetes or hypertension) Exclusion Criteria: Contraindications for cardiac MR

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Myocarditis<br>Patients with strong clinical evidence for acute myocarditis (recent infection, elevated troponin and white blood cell count). | Other: Cardiac magnetic resonance scan<br> <br> |
| Healthy Controls<br>Healthy volunteers without any signs of cardiac disease. | Other: Cardiac magnetic resonance scan<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myocardial T1 relaxation time | Changes in myocardial T1 relaxation time is of interest in patients with acute myocarditis. T1 relaxation times will be directly obtained from the T1 maps through ROI analysis. T1 maps will be analyzed using a segmental approach. T1 relaxation times are given in [ms]. | Measurement will be performed within 2 weeks after MRI scan. | 
| Myocardial T2 relaxation time | Changes in myocardial T2 relaxation time is of interest in patients with acute myocarditis. T2 relaxation times will be directly obtained from T2 maps through ROI analysis. T2 maps will be analyzed using a segmental approach. T2 relaxation times are given in [ms]. | Measurement will be performed within 2 weeks after MRI scan. | 
| Myocardial ECV measurements | Changes in myocardial ECV parameters is of interest in patients with acute myocarditis. Hematocrit corrected ECV will be calculated using pre- and post-contrast T1 values for myocardium and blood pool using following formula: ECV= (1⁄T1 myocardium post contrast-1⁄T1 myocadium pre contrast)/(1⁄T1 blood post contrast-1⁄ T1 blood pre contrast) x (1-hematocrit). ECV is given in percentage. | Measurement will be performed within 2 weeks after MRI scan. | 
| Myocardial strain analysis (focussed on longitudinal strain) | Changes in longitudinal strain as determined by echocardiography has been described in patient with acute myocarditis. In our study longitudinal strain is measured using feature tracking, which allows for strain calculation from standard MR cine datasets. | Measurement will be performed within 2 weeks after MRI scan. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Magnetic Resonance Imaging, Diagnostic Imaging