Atrial and ventricular strain using cardiovascular magnetic resonance in the prediction of outcomes of pericarditis patients: a pilot study

Category	Detail
Condition	Acute pericarditis, an inflammation of the pericardial layers with diverse etiologies including infections, autoimmune, metabolic diseases, radiation, or iatrogenic causes.
Key Mechanisms	Inflammation of pericardial layers; myocardial involvement assessed via cardiovascular magnetic resonance (CMR) including atrial and ventricular strain parameters.
Target Population	Patients with first episode of acute pericarditis diagnosed clinically and undergoing CMR within 7 days of symptom onset.
Care Setting	Hospital setting with access to advanced cardiovascular imaging including CMR.

CMR is a non-invasive imaging modality effective for anatomical and tissue characterization of pericardial layers and myocardial involvement.
Positive late gadolinium enhancement (LGE) in pericardial layers on CMR is associated with recurrence of pericardial events.
CMR feature tracking enables quantitative assessment of atrial and ventricular strain without additional contrast or sequences, offering prognostic insights.

Diagnosis of acute pericarditis relies on clinical symptoms, ECG changes, and echocardiography per ESC guidelines.
CMR is recommended to assess myocardial involvement and exclude ischemia when coronary artery disease is not significant.

Use CMR findings, including LGE and strain parameters, to inform prognosis and guide management strategies.

Monitor patients with positive pericardial LGE for recurrence risk.
Consider serial CMR and strain analysis for risk stratification in acute pericarditis.

Exclude patients with prior myocardial infarction, cardiomyopathy, atrial fibrillation, chronic/recurrent pericarditis, or irreversible myocardial damage from CMR strain assessment for acute pericarditis.

Adults with first episode acute pericarditis undergoing CMR within 7 days of symptom onset.

CMR-derived atrial and ventricular strain parameters may predict clinical outcomes and recurrence risk, potentially guiding personalized treatment.

Perform CMR within 7 days of symptom onset for accurate assessment of pericardial inflammation and myocardial strain.
Use feature tracking software to quantify atrial and ventricular strain from standard cine CMR images without additional contrast.
Exclude confounding cardiac conditions to ensure accurate interpretation of strain parameters in acute pericarditis.
Incorporate CMR findings with clinical and ECG data for comprehensive diagnosis and risk stratification.

Clinical Scorecard: Assessment of Atrial and Ventricular Strain via Cardiovascular Magnetic Resonance for Predicting Outcomes in Patients with Pericarditis: A Preliminary Investigation