ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Dynamic Change of Left Ventricular Mechanics in Patients with Acute Myocarditis with Preserved Left Ventricular Systolic Function: A 2-Year Follow-up Study [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2022; 50(7): 485-491 | DOI: 10.5543/tkda.2022.22358

Dynamic Change of Left Ventricular Mechanics in Patients with Acute Myocarditis with Preserved Left Ventricular Systolic Function: A 2-Year Follow-up Study

Esra Poyraz, Lale Dinç Asarcıklı
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, İstanbul, Turkey


OBJECTIVE
Acute myocarditis mimics acute coronary syndrome due to its clinical course and presentation. This study aimed to evaluate left ventricular longitudinal and circumferential functions during the acute phase and late phase of acute myocarditis with preserved left ventricular ejection fraction using 2-dimensional speckle tracking echocardiography.


METHODS
Forty-one consecutive acute myocarditis patients with preserved left ventricular ejection fraction confirmed by cardiac magnetic resonance imaging underwent 2-dimensional speckle tracking echocardiography within the first week of hospital admission. Findings were compared with age and sex-matched 40 healthy controls. Left ventricular mechanics of the study group were reevaluated by 2-dimensional speckle tracking echocardiography during followup (23.85 ± 6.65 months later).


RESULTS
Myocardial lesions with late gadolinium enhancement on cardiac magnetic resonance imaging were mostly localized in the subepicardial layer (91.40%) and commonly observed in the inferolateral wall (42.94%). Consistent with the cardiac magnetic resonance imaging findings, 2-dimensional speckle tracking echocardiography showed the localization of the involved myocardial segments with prominent impairment in global longitudinal peak systolic strain and global circumferential strain of the inferolateral wall of the left ventricle. In the acute phase, global longitudinal peak systolic strain (−17.32 ± 2.02 vs −20.59 ± 2.38) and global circumferential strain (−22.33 ± 2.27 vs −24.85 ± 3.19) were found to be lower in patients with acute myocarditis compared to healthy controls (both P <.001). While global circumferential strain was improved in the late phase compared with the acute phase (from −22.28 ± 2.32 to −22.90 ± 2.65; P =.003), global longitudinal peak systolic strain was not significantly changed during follow-up (from −17.30 ± 2.09 to –17.62 ± 2.19; P =.072).


CONCLUSION
Subtle left ventricular systolic function impairment can be detected by the
2-dimensional speckle tracking echocardiography technique in patients with acute myocarditis with preserved left ventricular ejection fraction and improvement in circumferential function could be observed during follow-up.

Keywords: Acute myocarditis, global circumferential strain, global longitudinal strain, speckle tracking echocardiography

How to cite this article
Esra Poyraz, Lale Dinç Asarcıklı. Dynamic Change of Left Ventricular Mechanics in Patients with Acute Myocarditis with Preserved Left Ventricular Systolic Function: A 2-Year Follow-up Study. Turk Kardiyol Dern Ars. 2022; 50(7): 485-491

Corresponding Author: Esra Poyraz
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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