Left ventricular endocardial longitudinal dysfunction persists after acute myocarditis with preserved ejection fraction

Background: The aim of present study was to assess left ventricular (LV) myocardial deformation and changes over time in patients with acute myocarditis (AM) with pre- served ejection fraction detected by late gadolinium enhancement (LGE) magnetic resonance imaging. Methods: Thirty-five male patients with AM diagnoses and preserved systolic func- tion based on cardiac magnetic resonance imaging (MRI) were prospectively enrolled. On admission, echocardiography with measurements of global and segmental longi- tudinal (LS) strains was performed both at the endocardial (ENDO) and epicardial (EPI) levels. Findings were compared to 25 control subjects. Twenty-six patients were also monitored over a 22-month follow-up (FU group). Results: On admission, global ENDO-LS was poorer in magnitude in AM (−19.2 ± 3.1) than in controls (−24.0±1.05) (P<0.0001), whereas EPI-LS was not different (−20.6 ± 3.4 vs −19.7 ± 6 P = NS). A functional increase in magnitude in both ENDO- LS (−20.8±5.4, P=NS) and EPI-LS (−22.6±4.6, P=0.02) was found in FU vs AM patients. Conclusions: The present study demonstrates a steady ENDO-LS impairment in infarct-like AM during a 2-year follow-up period, despite a preserved LV ejection fraction.