The purpose of our study was to compare diagnostic performance of old and new Lake Louise Criteria (oLLC and nLLC) among different clinical presentations: infarct-like (IL), cardiomyopathic (CM) and arrhythmic (AR). 102 patients with clinical suspicion of acute myocarditis underwent cardiac magnetic resonance (CMR) on a 1.5 T scanner. Protocol included cine-SSFP, T2-weighted STIR, T2 mapping, early and late gadolinium enhancement and T1 mapping acquired before and after gadolinium administration. The degree of agreement has been calculated with Cohen's K test. 42 patients also underwent endomyocardial biopsy (EMB). IL onset was present in 54/102 patients, CM in 28/102 and AR in 20/102. nLLC were positive in 58.3% of the patients, while oLLC in 37.9%, k = 0.57 (IC: 0.428-0.713). The degree of agreement between nLLC and oLLC was 0.49 (IC: 0.111-0.876) for AR onset (nLLC positive in 35% vs oLLC in 15%), 0.25 (IC: 0.035-0.459) for CM pattern (nLLC positive in 60.7% vs oLLC 17.9%) and 0.73 (IC: 0.543-0.912) for IL presentation (nLLC positive in 66.7% vs oLLC in 57.4%). Diagnostic accuracy was 75% for both nLLC and oLLC among IL onset, and 41.6% for oLLC vs 66.7% for nLLC, as regards CM clinical presentation. nLLC have improved diagnostic performance of CMR for the diagnosis of acute myocarditis, in particular for atypical clinical presentation.

Use of the new Lake Louise Criteria improves CMR detection of atypical forms of acute myocarditis / Cundari, Giulia; Galea, Nicola; De Rubeis, Gianluca; Frustaci, Andrea; Cilia, Francesco; Mancuso, Giuseppe; Marchitelli, Livia; Catapano, Federica; Carbone, Iacopo; Catalano, Carlo; Francone, Marco. - In: THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING. - ISSN 1569-5794. - (2020). [10.1007/s10554-020-02097-9]

Use of the new Lake Louise Criteria improves CMR detection of atypical forms of acute myocarditis

Cundari, Giulia
Primo
;
Galea, Nicola
Secondo
;
De Rubeis, Gianluca;Frustaci, Andrea;Cilia, Francesco;Mancuso, Giuseppe;Marchitelli, Livia;Catapano, Federica;Carbone, Iacopo;Catalano, Carlo
Penultimo
;
Francone, Marco
Ultimo
2020

Abstract

The purpose of our study was to compare diagnostic performance of old and new Lake Louise Criteria (oLLC and nLLC) among different clinical presentations: infarct-like (IL), cardiomyopathic (CM) and arrhythmic (AR). 102 patients with clinical suspicion of acute myocarditis underwent cardiac magnetic resonance (CMR) on a 1.5 T scanner. Protocol included cine-SSFP, T2-weighted STIR, T2 mapping, early and late gadolinium enhancement and T1 mapping acquired before and after gadolinium administration. The degree of agreement has been calculated with Cohen's K test. 42 patients also underwent endomyocardial biopsy (EMB). IL onset was present in 54/102 patients, CM in 28/102 and AR in 20/102. nLLC were positive in 58.3% of the patients, while oLLC in 37.9%, k = 0.57 (IC: 0.428-0.713). The degree of agreement between nLLC and oLLC was 0.49 (IC: 0.111-0.876) for AR onset (nLLC positive in 35% vs oLLC in 15%), 0.25 (IC: 0.035-0.459) for CM pattern (nLLC positive in 60.7% vs oLLC 17.9%) and 0.73 (IC: 0.543-0.912) for IL presentation (nLLC positive in 66.7% vs oLLC in 57.4%). Diagnostic accuracy was 75% for both nLLC and oLLC among IL onset, and 41.6% for oLLC vs 66.7% for nLLC, as regards CM clinical presentation. nLLC have improved diagnostic performance of CMR for the diagnosis of acute myocarditis, in particular for atypical clinical presentation.
2020
agreement; atypical onsets; diagnostic accuracy; Lake Louise criteria; myocarditis
01 Pubblicazione su rivista::01a Articolo in rivista
Use of the new Lake Louise Criteria improves CMR detection of atypical forms of acute myocarditis / Cundari, Giulia; Galea, Nicola; De Rubeis, Gianluca; Frustaci, Andrea; Cilia, Francesco; Mancuso, Giuseppe; Marchitelli, Livia; Catapano, Federica; Carbone, Iacopo; Catalano, Carlo; Francone, Marco. - In: THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING. - ISSN 1569-5794. - (2020). [10.1007/s10554-020-02097-9]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1458819
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