Long-term follow-up of patients paragraph sign with acute myocarditis by magnetic paragraph sign resonance imaging

MAGMA. 2003 Feb;16(1):17-20. doi: 10.1007/s10334-003-0007-7.


Magnetic resonance imaging (MRI) reveals cardiac signal intensity changes in patients with acute myocarditis; however, the natural history of these changes and their relationship to individual outcomes are unknown. The relationship of MRI findings to long-term outcome was studied by serial MRI studies in 16 patients with acute myocarditis who were followed for 30+/-4 (SE) months. Myocardial contrast enhancement was monitored using contrast-enhanced T1-weighted fast spin-echo images. Left ventricular ejection fraction was measured with gradient-echo sequences. Clinical symptoms were scored. The results were compared to a control group of 26 age-matched, healthy volunteers. Myocardial contrast enhancement, which was markedly increased in the early course of the disease, decreased at 4 weeks and remained within the normal range in most patients after 30 months. Contrast enhancement 4 weeks after onset of symptoms was predictive for the functional and clinical long-term outcome.Contrast-enhanced MRI may be a useful, noninvasive tool for longterm follow-up of patients with acute myocarditis. Furthermore, relatively early MRI findings may predict longer-term outcomes.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Validation Study

MeSH terms

  • Acute Disease
  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods*
  • Myocarditis / complications
  • Myocarditis / diagnosis*
  • Myocarditis / drug therapy
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Statistics as Topic
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / etiology


  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors