{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:09:44Z","timestamp":1784646584748,"version":"3.55.0"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Silesia","award":["PCN-1-189\/K\/2\/K"],"award-info":[{"award-number":["PCN-1-189\/K\/2\/K"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Left ventricle (LV) systolic dysfunction, defined as a global (LVejection fraction, LVEF &lt; 50%) and\/or regional wall motion abnormalities (RWMA), are the major parameters assessed in patients with cardiovascular diseases. The study evaluated the predictive value of LV systolic dysfunction for non-ischemic myocardial injury (presence of myocardial fibrosis\/scar) in patients with suspected myocarditis. Methods: This was a multicenter, observational, retrospective study (2018\u20132021) of stable outpatients with clinically suspected myocarditis referred for a contrast-enhanced CMR. Patients with a history of any other significant cardiovascular disorders were excluded from the study. In each patient, the LV systolic function (LVEF, RWMA) and the presence and severity of late gadolinium enhancement (LGE) were assessed by CMR. Results: A total of 773 consecutive patients were enrolled in the study. The average LVEF was 58 \u00b1 10%, and systolic dysfunction was observed in 95 cases (12%). Subsequently, 456 patients (59%) with confirmed non-ischemic LGE in at least one segment were included in the study group. The average LVEF was 57 \u00b1 11%, with LV systolic dysfunction observed in 126 (28%) individuals with RWMA and 84 (18%) with LVEF &lt; 50%. The median number of LV segments with LGE was 3 (2\u20135), and the total amount of LGE was 6% (3\u201310) of the LV mass. The wall motion score index (WMSI) &gt; 1 and LVEF &lt; 56% were the best predictors of non-ischemic injury based on LGE (area under the curve [AUC] 0.62; sensitivity 31%; specificity 94%; p &lt; 0.001 and AUC 0.59; sensitivity 42%; specificity 75%, p &lt; 0.001, respectively). Conclusions: In stable patients with suspected myocarditis, any RWMA and LVEF &lt; 56% had a predictive value for a non-ischemic myocardial injury as assessed by CMR.<\/jats:p>","DOI":"10.3390\/jcm14113691","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:26:50Z","timestamp":1748204810000},"page":"3691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Value of Left Ventricular Systolic Dysfunction or Wall Motion Abnormalities for Non-Ischemic Myocardial Injury: A Multicenter Cardiovascular Resonance Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4759-5879","authenticated-orcid":false,"given":"Justyna M.","family":"Sokolska","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Imaging, Faculty of Medicine, Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wroc\u0142aw, Poland"},{"name":"Institute of Heart Diseases, Wroclaw University Hospital, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Rajewska-Tabor","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Poznan University of Medical Sciences, 61-848 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-4802","authenticated-orcid":false,"given":"Marek","family":"Kozi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kociewie Health Center, 83-200 Starogard Gda\u0144ski, Poland"},{"name":"1st Department of Cardiology, Medical University of Gdansk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Kulawiak-Ga\u0142\u0105ska","sequence":"additional","affiliation":[{"name":"2nd Department of Radiology, Medical University of Gda\u0144sk, 80-214 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Jankowska","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Stefan Cardinal Wyszynski Regional Specialist Hospital, 20-718 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Pyda","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Poznan University of Medical Sciences, 61-848 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol","family":"Miszalski-Jamka","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Department, Silesian Center for Heart Diseases, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2296-8827","authenticated-orcid":false,"given":"Maciej","family":"Haberka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Health Sciences, Medical University of Silesia, 40-635 Katowice, Poland"},{"name":"Department of Cardiovascular Imaging, Upper Silesian Medical Center of the Medical University of Silesia, 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1161\/CIRCULATIONAHA.112.112201","article-title":"Prognosis of individuals with asymptomatic left ventricular systolic dysfunction in the multi-ethnic study of atherosclerosis (MESA)","volume":"126","author":"Yeboah","year":"2012","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2851","DOI":"10.1161\/CIRCULATIONAHA.105.600437","article-title":"Stage B heart failure: Management of asymptomatic left ventricular systolic dysfunction","volume":"113","author":"Goldberg","year":"2006","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1093\/ehjci\/jeab149","article-title":"How-to: Focus Cardiac Ultrasound in acute settings","volume":"23","author":"Breithardt","year":"2022","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"108","DOI":"10.15420\/ecr.2012.8.2.108","article-title":"Measuring left ventricular ejection fraction-techniques and potential pitfalls","volume":"8","author":"Foley","year":"2012","journal-title":"Eur. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00059-007-2972-5","article-title":"Significance of late gadolinium enhancement in Cardiovascular Magnetic Resonance Imaging (CMR)","volume":"32","author":"Mahrholdt","year":"2007","journal-title":"Herz"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12968-023-00925-0","article-title":"Revisiting how we perform late gadolinium enhancement CMR: Insights gleaned over 25 years of clinical practice","volume":"25","author":"Jenista","year":"2023","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jacc.2024.10.080","article-title":"2024 ACC Expert Consensus Decision Pathway on Strategies and Criteria for the Diagnosis and Management of Myocarditis: A Report of the American College of Cardiology Solution Set Oversight Committee","volume":"4","author":"Drazner","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","unstructured":"World Health Organization (WHO) Consultation (2025, January 23). Definition and Diagnosis of Diabetes and Intermediate Hyperglycaemia. Available online: https:\/\/www.who.int\/publications\/i\/item\/definition-and-diagnosis-of-diabetes-mellitus-and-intermediate-hyperglycaemia."},{"key":"ref_11","unstructured":"(2025, January 25). Use of Glycated Haemoglobin (HbA1c) in Diagnosis of Diabetes Mellitus. Available online: https:\/\/www.who.int\/publications\/i\/item\/use-of-glycated-haemoglobin-(-hba1c)-in-diagnosis-of-diabetes-mellitus."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)","volume":"37","author":"Piepoli","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1016\/j.jacc.2018.09.072","article-title":"Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations","volume":"72","author":"Ferreira","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12968-020-00607-1","article-title":"Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update","volume":"22","author":"Kramer","year":"2020","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"463","DOI":"10.33963\/KP.a2023.0054","article-title":"A distinct septal pattern of late gadolinium enhancement specific for COVID-induced myocarditis: A multicenter cardiovascular magnetic resonance study","volume":"81","author":"Haberka","year":"2023","journal-title":"Pol. Heart J. (Kardiol. Pol.)"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/archinte.1916.00080130010002","article-title":"Clinical calorimetry: Tenth paper a formula to estimate the approximate surface area if height and weight be known","volume":"XVII","year":"1916","journal-title":"Arch. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1080\/10976640600572889","article-title":"Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance","volume":"8","author":"Maceira","year":"2006","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: A Statement for Healthcare Professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association","volume":"105","author":"Cerqueira","year":"2002","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/S0894-7317(89)80014-8","article-title":"Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms","volume":"2","author":"Schiller","year":"1989","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/0002-8703(85)90641-6","article-title":"The value of echocardiographic regional wall motion abnormalities in detecting coronary artery disease in patients with or without a dilated left ventricle","volume":"109","author":"Medina","year":"1985","journal-title":"Am. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S0735-1097(98)00632-9","article-title":"Prognostic value of dobutamine stress echocardiography in predicting cardiac events in patients with known or suspected coronary artery disease","volume":"33","author":"Krivokapich","year":"1999","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s10554-024-03059-1","article-title":"Prognostic value of visual and quantitative CMR regional myocardial function in patients with suspected myocarditis","volume":"4","author":"Bernhard","year":"2024","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.mri.2020.08.008","article-title":"Tissue-tracking in the assessment of late gadolinium enhancement in myocarditis and myocardial infarction","volume":"73","author":"Doimo","year":"2020","journal-title":"Magn. Reson. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.repc.2019.01.008","article-title":"Myocardial deformation measures by cardiac magnetic resonance tissue tracking in myocarditis: Relationship with systolic function and myocardial damage","volume":"11","author":"Ruivo","year":"2019","journal-title":"Rev. Port. Cardiol. (Engl. Ed.)"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/echo.14260","article-title":"Does myocardial strain remain abnormal long after normalization of ejection fraction in patients with acute myocarditis?","volume":"3","author":"Manalo","year":"2019","journal-title":"Echocardiography"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.mri.2018.08.004","article-title":"Left ventricular MRI wall motion assessment by monogenic signal amplitude image computation","volume":"54","author":"Benameur","year":"2018","journal-title":"Magn. Reson. Imaging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s10334-017-0609-0","article-title":"Interpretation of cardiac wall motion from cine-MRI combined with parametric imaging based on the Hilbert transform","volume":"4","author":"Benameur","year":"2017","journal-title":"Magn. Reson. Mater. Phys. Biol. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jcmg.2022.12.024","article-title":"Diagnostic Accuracy of CMR with Late Gadolinium Enhancement for Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis","volume":"3","author":"Papanastasiou","year":"2023","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e000053","DOI":"10.1161\/HCI.0000000000000053","article-title":"State of the Art: Imaging for Myocardial Viability: A Scientific Statement From the American Heart Association","volume":"7","author":"Garcia","year":"2020","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1161\/01.CIR.0000120294.67948.E3","article-title":"Role of cardiac magnetic resonance imaging in the assessment of myocardial viability","volume":"11","author":"Shan","year":"2004","journal-title":"Circulation"},{"key":"ref_31","first-page":"7264","article-title":"Comparative analysis of late gadolinium enhancement assessment techniques for monitoring fibrotic changes in myocarditis follow-up","volume":"11","author":"Polacin","year":"2024","journal-title":"Eur. Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.jcmg.2022.12.029","article-title":"Diagnostic and prognostic role of cardiac magnetic resonance in MINOCA","volume":"16","author":"Mileva","year":"2023","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Meier, C., Eisenbl\u00e4tter, M., and Gielen, S. (2024). Myocardial Late Gadolinium Enhancement (LGE) in Cardiac Magnetic Resonance Imaging (CMR)\u2014An Important Risk Marker for Cardiac Disease. J. Cardiovasc. Dev. Dis., 2.","DOI":"10.3390\/jcdd11020040"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1093\/eurheartj\/ehi258","article-title":"Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies","volume":"15","author":"Mahrholdt","year":"2005","journal-title":"Eur Heart J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.ijcard.2017.10.094","article-title":"Impact of Late Gadolinium Enhancement on mortality, sudden death and major adverse cardiovascular events in ischemic and nonischemic cardiomyopathy: A systematic review and meta-analysis","volume":"254","author":"Ganesan","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e15854","DOI":"10.1111\/echo.15854","article-title":"Clinical impact of multimodality assessment of myocardial viability","volume":"7","author":"Canton","year":"2024","journal-title":"Echocardiography"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1161\/CIRCIMAGING.113.001144","article-title":"Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: A systematic review and meta-analysis","volume":"2","author":"Kuruvilla","year":"2014","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e011492","DOI":"10.1161\/CIRCIMAGING.120.011492","article-title":"Prognostic Impact of Late Gadolinium Enhancement by Cardiovascular Magnetic Resonance in Myocarditis: A Systematic Review and Meta-Analysis","volume":"1","author":"Georgiopoulos","year":"2021","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1016\/j.crad.2022.12.015","article-title":"The extent of late gadolinium enhancement predicts mortality, sudden death and major adverse cardiovascular events in patients with nonischaemic cardiomyopathy: A systematic review and meta-analysis","volume":"4","author":"Golukhova","year":"2023","journal-title":"Clin. Radiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"102735","DOI":"10.1016\/j.cpcardiol.2024.102735","article-title":"Global burden of myocarditis in youth and middle age (1990\u20132019): A systematic analysis of the disease burden and thirty-year forecast","volume":"9","author":"Zhang","year":"2024","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1161\/CIRCIMAGING.113.000416","article-title":"Cardiac magnetic resonance assessment of myocarditis","volume":"6","author":"Friedrich","year":"2013","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3960","DOI":"10.1097\/MS9.0000000000001040","article-title":"Diagnostic criteria for myocarditis on cardiac magnetic resonance imaging: An educational review","volume":"85","author":"Joudar","year":"2023","journal-title":"Ann. Med. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3691\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:39:56Z","timestamp":1760031596000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14113691"],"URL":"https:\/\/doi.org\/10.3390\/jcm14113691","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,24]]}}}