SEE PAGES 1964 AND 1977 M yocarditis is a common inflammatory heart disease. Because the symptoms and clinical presentation are highly variable, the correct diagnosis remains challenging. Moreover, the clinical course may range from complete recovery to end-stage heart failure, and autopsy data demonstrate that myocarditis is responsible for 5% to 20% of sudden deaths in young adults (1). Thus, a reliable tool for work-up and risk stratification in myocarditis is needed. Cardiovascular magnetic resonance (CMR) seems to be the method of choice. Myocarditis-induced inflammatory and fibrotic alterations lead to acute myocardial necrosis and/or chronic scarring/fibrosis, which is characterized by mostly subepicardial and/or intramural regions of late gadolinium enhancement (LGE), often with a patchy distribution and frequently located in the posterolateral wall (2). Apart from its diagnostic benefit, CMR has proven prognostic value, because LGE-positive patients are at increased risk for adverse events. A study in more than 220 patients with biopsy-proven myocarditis revealed the presence of LGE as the best independent predictor of all-cause and cardiac mortality (3). Conversely, LGE-negative patients have an excellent prognosis independent of their clinical symptoms (4). However, some questions remain:

中文翻译：

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心肌炎的预后

参见 1964 和 1977 页 心肌炎是一种常见的炎症性心脏病。由于症状和临床表现差异很大，正确的诊断仍然具有挑战性。此外，临床过程可能从完全康复到终末期心力衰竭，尸检数据表明，5% 至 20% 的年轻人猝死是由心肌炎引起的 (1)。因此，需要一种可靠的心肌炎检查和风险分层工具。心血管磁共振 (CMR) 似乎是首选方法。心肌炎引起的炎症和纤维化改变导致急性心肌坏死和/或慢性瘢痕形成/纤维化，其特征主要是心外膜下和/或壁内区域的晚期钆增强 (LGE)，常呈片状分布，常位于后侧壁 (2)。除了其诊断益处外，CMR 已被证明具有预后价值，因为 LGE 阳性患者发生不良事件的风险增加。一项针对 220 多名经活检证实的心肌炎患者的研究表明，LGE 的存在是全因死亡率和心源性死亡率的最佳独立预测因素 (3)。相反，LGE 阴性患者的预后良好，与其临床症状无关 (4)。但是，仍然存在一些问题：相反，LGE 阴性患者的预后良好，与其临床症状无关 (4)。但是，仍然存在一些问题：相反，LGE 阴性患者的预后良好，与其临床症状无关 (4)。但是，仍然存在一些问题：