Prognostic value of mitral annular plane systolic excursion for adverse cardiovascular events in patients with acute myocarditis

Purpose Mitral annular plane systolic excursion (MAPSE) has prognostic value as a surrogate indicator of ventricular function in cardiovascular disease, but its prognostic value in patients with acute myocarditis is unclear. Methods Our cohort included 46 patients with acute myocarditis and 26 healthy controls, all of whom underwent cardiac magnetic resonance. Left atrial and left ventricular strain and MAPSE were assessed using feature tracking, and patients were followed up in a group that experienced a major adverse cardiovascular event (MACE) ( n = 11) and a group that did not experience a MACE ( n = 35). Cox regression modelling was used to assess the prognostic value of MAPSE in acute myocarditis. Results Left ventricular strain parameters (including global longitudinal, circumferential, and radial strain), left atrial strain parameters (reservoir and conduit strain), and MAPSE were significantly reduced compared with patients without MACE. Receiver operating characteristic (ROC) curve showed that MAPSE had a higher area under the curve (AUC) in identifying MACE. By Kaplan–Meier analysis, the risk of death increased significantly with decreasing lateral and septal MAPSE (log-rank P = 0.0025, P = 0.0065). After adjusting for clinical and imaging risk factors, age (HR 1.139, 95%CI 1.056–1.228), lateral MAPSE (HR 0.594, 95%CI 0.355–0.955), and septal MAPSE (HR 0.647, 95%CI 0.420–0.995) were significantly associated with MACE. The ROC curves showed that the model including both lateral and septal MAPSE did not improve predictive performance compared to lateral MAPSE alone (AUC = 0.8831 vs. AUC = 0.9095). Conclusion MAPSE has prognostic value for adverse cardiovascular events in patients with acute myocarditis, and lateral MAPSE has better predictive performance.