Myoglobin for Detection of High-Risk Patients with Acute Myocarditis
Jan Kottwitz, Katelyn A. Bruno, Jan Berg, Gary R. Salomon, DeLisa Fairweather, Mawahib Elhassan, Nora Baltensperger, Christine K. Kissel, Marina Lovrinovic, Andrea Baltensweiler, Christian Schmied, Christian Templin, João A.C. Lima, Ulf Landmesser, Thomas F. Lüscher, Robert Manka, Bettina Heidecker
Abstract
Abstract There is an unmet need for accurate and practical screening to detect myocarditis. We sought to test the hypothesis that the extent of acute myocarditis, measured by late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR), can be estimated based on routine blood markers. A total of 44 patients were diagnosed with acute myocarditis and included in this study. There was strong correlation between myoglobin and LGE (r s = 0.73 [95% CI 0.51; 0.87], p < 0.001), while correlation was weak between LGE and TnT-hs (r s = 0.37 [95% CI 0.09; 0.61], p = 0.01). Receiver operating curve (ROC) analysis determined myoglobin ≥ 87 μg/L as cutoff to identify myocarditis (92% sensitivity, 80% specificity). The data were reproduced in an established model of coxsackievirus B3 myocarditis in mice ( n = 26). These data suggest that myoglobin is an accurate marker of acute myocarditis.