Evidence map›Paper›PMID 30813942›Full record

Observational studyJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2019

Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis.

Christoph Gräni, Christian Eichhorn, Loïc Bière, Kyoichi Kaneko, Venkatesh L Murthy, Vikram Agarwal, Ayaz Aghayev, Michael Steigner, Ron Blankstein, Michael Jerosch-Herold and 1 more

2 registry-linked trialsAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 62 papers.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03470571 completednot on this map

Predictive Value of CMR Features in Patients With Suspected Myocarditis

TypeobservationalSponsorBrigham and Women's HospitalRan2016 to 2018Enrolled670ConditionsOutcome, FatalArmsCMR
NCT04913727 narecruitingnot on this mapstarted 2021, after this paper: background citation

Prediction of Reverse Remodeling and Outcome in Patients With Severe Secondary Mitral Valve Regurgitation Undergoing Transcatheter Edge-to-edge Mitral Valve Repair

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2021 to 2025Enrolled300ConditionsSevere Mitral RegurgitationArmsCardiac magnetic resonance imaging before the procedure, Transcatheter mitral edge-to-edge repair.
3 · Its place in the literature

Who cites it

62 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Cardiac Magnetic Resonance in Heart Failure: Diagnostic and Prognostic Assessments.Journal of cardiovascular development and disease · 2025
    Review
  10. Article
  11. Review
  12. Article
  13. Article
  14. Management Status of Myocarditis-Related Sudden Cardiac Death.Reviews in cardiovascular medicine · 2024
    Review
  15. Vitamin D Status and Cardiovascular Disease in College Athletes After SARS-CoV-2 Infection.Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine · 2024
    Article
  16. Article
  17. Review
  18. HAMIL-QA: Hierarchical Approach to Multiple Instance Learning for Atrial LGE MRI Quality Assessment.Medical image computing and computer-assisted intervention : MICCAI ... International Conference on Medical Image Computing and Computer-Assisted Intervention · 2024
    Article
  19. Article
  20. Review

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Christoph GräniNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Christian EichhornNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Loïc BièreNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Kyoichi KanekoNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Venkatesh L MurthyCardiovascular Imaging, Department of Radiology, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA.
Vikram AgarwalNoninvasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ayaz AghayevNoninvasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Michael SteignerNoninvasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ron BlanksteinNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Michael Jerosch-HeroldNoninvasive Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Raymond Y KwongNoninvasive Cardiovascular Imaging, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. rykwong@bwh.harvard.edu.

Funding

HCMR Novel Markers of Prognosis in Hypertrophic CardiomyopathyU01HL117006 · NHLBI · UNIVERSITY OF VIRGINIA · PI KRAMER, CHRISTOPHER M., NEUBAUER, STEFAN · 2013 to 2017
$14.5M
Blood Pressure in Dialysis PatientsR01DK083424 · NIDDK · UNIVERSITY OF NEW MEXICO · PI MISKULIN, DANA C, PLOTH, DAVID W · 2010 to 2012
$1.6M
Plasma miRNA predictors of adverse mechanical and electrical remodeling after MIUH2TR000901 · NCATS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI DAS, SAUMYA, KWONG, RAYMOND Y · 2013 to 2014
$1.1M
NCATS NIH HHS UH2 TR000901NHLBI NIH HHS U01 HL117006NIDDK NIH HHS R01 DK083424
6 · The paper itself

Abstract

backgroundAlthough the presence of late gadolinium enhancement (LGE) using cardiovascular magnetic resonance imaging (CMR) is a significant discriminator of events in patients with suspected myocarditis, no data are available on the optimal LGE quantification method.

methodsSix hundred seventy consecutive patients (48 ± 16 years, 59% male) with suspected myocarditis were enrolled between 2002 and 2015. We performed LGE quantitation using seven different signal intensity thresholding methods based either on 2, 3, 4, 5, 6, 7 standard deviations (SD) above remote myocardium or full width at half maximum (FWHM). In addition, a LGE visual presence score (LGE-VPS) (LGE present/absent in each segment) was assessed. For each of these methods, the strength of association of LGE results with major adverse cardiac events (MACE) was determined. Inter-and intra-rater variability using intraclass-correlation coefficient (ICC) was performed for all methods.

resultsNinety-eight (15%) patients experienced a MACE at a medium follow-up of 4.7 years. LGE quantification by FWHM, 2- and 3-SD demonstrated univariable association with MACE (hazard ratio [HR] 1.05, 95% confidence interval [CI]:1.02-1.08, p = 0.001; HR 1.02, 95%CI:1.00-1.04; p = 0.001; HR 1.02, 95%CI: 1.00-1.05, p = 0.035, respectively), whereas 4-SD through 7-SD methods did not reach significant association. LGE-VPS also demonstrated association with MACE (HR 1.09, 95%CI: 1.04-1.15, p < 0.001). In the multivariable model, FWHM, 2-SD methods, and LGE-VPS each demonstrated significant association with MACE adjusted to age, sex, BMI and LVEF (adjusted HR of 1.04, 1.02, and 1.07; p = 0.009, p = 0.035; and p = 0.005, respectively). In these, FWHM and LGE-VPS had the highest degrees of inter and intra-rater reproducibility based on their high ICC values.

conclusionsFWHM is the optimal semi-automated quantification method in risk-stratifying patients with suspected myocarditis, demonstrating the strongest association with MACE and the highest technical consistency. Visual LGE scoring is a reliable alternative method and is associated with a comparable association with MACE and reproducibility in these patients. TRIAL REGISTRATION NUMBER: NCT03470571 . Registered 13th March 2018. Retrospectively registered.

Indexed as

AdultContrast MediaFemaleFibrosisGadolinium DTPAHumansImage Interpretation, Computer-AssistedMagnetic Resonance ImagingMaleMeglumineMiddle AgedMyocarditisMyocardiumOrganometallic CompoundsPredictive Value of TestsPrognosisContrast Mediagadobenic acidGadolinium DTPAMeglumineOrganometallic CompoundsCardiovascular magnetic resonance imagingCMRFull width half maximumFWHMMACEMyocarditisOutcomeQuantification methodSDStandard deviation

Identifiers

PMID30813942
PMCPMC6393997

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.