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There is increasing role for cardiac magnetic resonance imaging (CMR) and inflammatory markers (IM) in pericardial syndromes. We sought to examine this correlation in pericarditis patients who had serial CMR studies.
From the Cleveland Clinic pericardial database, we identified 171 consecutive pericarditis patients (mean age 48 +/-15 yrs, 49% female, 68% recurrent pericarditis, 65% idiopathic etiology) who had CMR performed between 2007-2012, and IM (CRP and WSR) measured within a week of CMR (Table 1). There was a statistically significant correlation between IM and LGE (CRP r=0.21, p=0.009; WSR r=0.22, p=0.05). At follow-up (mean=224 +/- 198 days), 57 patients (33%) had a CMR showing no change in 27 (47%), improvement in 23 (40%) and worsening in 7 (12%). Patients with improved LGE had decrease in WSR (27+/-37), while those without change or worsening of LGE had no change in WSR (p=0.03), and similarly for CRP. These findings persist in serial studies (CRP r=0.22, p=0.09; WSR r=0.27, p=0.05). On ROC analysis, a lack of change or increase in WSR was associated with persistence or worsening of LGE with 80% specificity (AUC=0.70, p=0.018), and similarly for CRP. There was no correlation between symptoms and serial LGE or IM.
CMR with LGE and IM have a modest, but statistically significant correlation in patients with pericarditis. This correlation persists with high specificity as the disease progresses. Further studies are needed to evaluate the role of CMR in the diagnosis and management of pericardial syndromes.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pericardial Diseases
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 1250-151
- 2013 American College of Cardiology Foundation