T2 mapping in acute myocarditis: advancing quantitative cardiovascular magnetic resonance (CMR) imaging for precision medicine.

AIM: Myocarditis is an inflammatory condition characterised by myocardial oedema, which is a key diagnostic criterion. The introduction of T2 mapping techniques has enabled the quantitative assessment of myocardial oedema using cardiovascular magnetic resonance (CMR). This study investigated the demographic, laboratory, clinical, and CMR correlates of T2 mapping in patients with acute myocarditis.

MATERIALS AND

METHODS

This retrospective study included 141 consecutive patients with acute myocarditis (113 males, mean age 41.12 ± 19.64 years). All patients met the diagnostic criteria for clinically suspected myocarditis with an acute presentation and underwent CMR examinations that fulfilled the Lake Louise Criteria.

RESULTS

The mean T2 mapping value in patients was 60.12 ± 6.28 ms. Significantly higher T2 mapping values were observed in patients with hypertension (P = 0.039), impaired left ventricular ejection fraction (P = 0.001), impaired longitudinal strain (P = 0.002), and late gadolinium enhancement (LGE) in the septum (P = 0.023). On multivariable linear regression analysis, decreased left ventricle ejection fraction (LVEF) (Beta = -2.584, P = 0.014) and greater LGE extent (Beta = 2.166, P = 0.034) were independently associated with elevated T2 mapping values.

CONCLUSION

Elevated T2 mapping values are strongly associated with imaging markers of disease severity in acute myocarditis, underscoring its role in the comprehensive evaluation of myocardial inflammation.