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  • Open Access

Role of C reactive protein in evaluating the extent of myocardial inflammation in acute myocarditis

  • 1,
  • 2,
  • 2,
  • 2,
  • 1,
  • 1 and
  • 2
Journal of Cardiovascular Magnetic Resonance201517 (Suppl 1) :P291

https://doi.org/10.1186/1532-429X-17-S1-P291

  • Published:

Keywords

  • Leave Ventricular Ejection Fraction
  • Myocarditis
  • Late Gadolinium Enhancement
  • Left Ventricular Mass
  • Myocardial Damage

Background

Cardiac MRI (CMR) is an excellent modality for myocardial tissue characterization, allowing demonstration and quantification of myocardial damage using late Gadolinium enhancement (LGE) sequence. C Reactive Protein (CRP) has been shown to be a prognostic marker in lymphocytic myocarditis. The purpose of this study was to study the correlation between CRP levels and the extent of myocardial damage in patients diagnosed with myocarditis.

Methods

The study cohort included 47 patients (Mean age 32.5±12, 89% males) admitted to the heart center with MRI proven acute myocarditis. Demographic, clinical, laboratory echocardiographic and CMR data was collected. CMR was performed using a 1.5 T scanner (Signa HDX GE medical systems) using a standardized protocol including SSFP and LGE sequnces. LGE was quantified as percentage of the left ventricular (LV) mass. Patients were divided into two groups: LGE< 10% of LV mass and LGE> 10.1% of LV mass. These two groups were compared in regards to CRP levels and left ventricular (LV) function.

Results

CRP levels were positively correlated with the myocardial damage; in the LGE< 10% group CRP was 54.6±56, in the and LGE> 10.1% group CRP was 104±68 (P value= 0.022). This correlation was maintained also when CRP was divided into thirtailes (P value=0.004). LV ejection fraction was 59.9%±6.7 VS 52.2%±12 for the lower and mid LGE thirtailes and upper LGE thirtaile, respectively (P value=0.023)

No correlation was found between the extent of myocardial damage (% LGE) and the CPK and Troponin levels or any of the baseline characteristics (table 1).
Table 1

Late Gd enhancement (LGE) percentage baseline characteristics and CRP CPK and Troponin levels

 

LGE<10% N= 16

LGE≥10% N= 31

P value

Age (Mean ± SD)

30.7±11

34.4±14

0.352

Diabetes mellitus

0

6.5

0.541

Hypertension

0

9.7

0.541

Dyslipidemia

0

16.1

0.150

Obesity

56.3

53.3

1

Smoker

31.3

29

1

CPK

560±680

612±427

0.779

Troponin

19.5±27

12±9.5

0.310

Troponin upper thirtile

31.3

29

1

LVEF

   

CRP

54.6±56

104±68

0.022

CRP upper thirtaile

21.4

63

0.012

CPK- Creatinin Phosphosokinase

LVEF- Left Ventricular Ejection Fraction

CRP-C Reactive protein

Conclusions

CRP was significantly and positively correlated with the extent of myocardial damage as quantified by CMR. It may serve as a simple yet valuable tool to predict LV damage and dysfunction in patients presenting with acute myocarditis.

Funding

No external funding was used for this study.

Authors’ Affiliations

(1)
Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
(2)
Heart Center, Sheba Medical Center, Tel Hashomer, Israel

Copyright

© Goitein et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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