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Group Covers Cardiovascular Imaging Use in Myocarditis

Last Updated: April 21, 2009.

The proper assessment of myocarditis using cardiovascular magnetic resonance is the subject of a white paper in the April 28 Journal of the American College of Cardiology.

TUESDAY, April 21 (HealthDay News) -- The proper assessment of myocarditis using cardiovascular magnetic resonance (CMR) is the subject of a white paper in the April 28 Journal of the American College of Cardiology.

Matthias G. Friedrich, M.D., of the Libin Cardiovascular Institute of Alberta in Canada, and colleagues write that history, physical examination, electrocardiogram, and serology all have limitations that reduce their diagnostic accuracy, and biopsy may not be appropriate in milder cases.

CMR has become a common tool for assessing suspected myocarditis. Criteria for requesting a CMR study include new onset or persistent symptoms of possible myocarditis, evidence supporting recent or ongoing myocardial injury, and suspected viral etiology, the authors note. CMR findings may include edema, hyperemia, capillary leak, left ventricular dysfunction, and pericardial effusion. The report for the CMR study should discuss left ventricular volume and function, any markers of inflammatory activity and injury, and suggested follow-up.

"The CMR methodology is evolving at a rapid pace. Among numerous interesting developments, many can be expected to be useful for application in myocarditis. As hardware and coil technology are improving, image quality and thus diagnostic yield will be more consistent. But, more importantly, novel approaches for characterizing tissue such as time-resolved assessment of gadolinium wash-out, T1 mapping, T2 mapping, parametric imaging, and the combination of imaging criteria with seromarkers will likely further increase the utility of CMR," the authors conclude.

Dr. Friedrich disclosed a financial relationship with Circle Cardiovascular Imaging, and Siemens Medical Solutions Canada and Berlex Canada Inc. helped support a meeting of the Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis.

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