Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Integrated Edema–Troponin Phenotyping Reveals Distinct Inflammatory and Structural Profiles in Acute Myocarditis
Session:
Sessão de Posters 42 - Para além da hipertrofia: as faces ocultas da doença miocárdica
Speaker:
Francisca Nunes
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.6 Myocardial Disease – Clinical
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Francisca Martins Nunes; Francisco Lemos de Sousa; Leonor Moura; Inês Rodrigues; António Gonçalves; André Lobo; Marta Catarina Almeida; Inês Neves; Marta Leite; Rita Faria; Nuno Dias Ferreira; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Background:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Acute myocarditis shows heterogeneous inflammatory and structural involvement. Troponin reflects necrosis, whereas CMR edema represents inflammatory burden; however, their combined use to define clinically meaningful phenotypes remains unexplored. We aimed to classify patients using integrated edema–troponin profiles and compare structural, functional and biochemical characteristics across phenotypes.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> We studied 126 patients with acute myocarditis. Edema extent and troponin T were dichotomized at the medians (6 segments; 884 ng/L), generating four phenotypes: High-Edema/High-TnT (1), High-Edema/Low-TnT (2), Low-Edema/High-TnT (3) and Low-Edema/Low-TnT (4, reference). Global differences were assessed with Kruskal–Wallis tests and pairwise Mann–Whitney U comparisons. Outcomes included LDH, NT-proBNP, indexed left ventricular mass (LVMi), left ventricular ejection fraction (LVEF) and follow-up late gadolinium enhancement (LGE) burden.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Results:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Significant overall differences were observed for LDH (p<0.001), LVMi (p=0.003), LVEF (p=0.007), NT-proBNP (p=0.018) and LGE extent (p≈0.001). Phenotype 1 showed markedly higher LDH (p<0.001), increased LVMi (p<0.001), higher NT-proBNP (p=0.0019), lower LVEF (p=0.009) and greater fibrosis (p=0.001) versus phenotype 4. Phenotype 2 showed elevated NT-proBNP (p=0.033) and reduced LVEF (p=0.004). Phenotype 3 displayed increased LDH (p=0.001) but preserved structural and functional measures.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Discussion:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> Integrating edema and troponin demonstrated four biologically coherent phenotypes. High-Edema/High-TnT reflected concordant inflammatory-necrotic injury, explaining its greater remodeling, dysfunction and fibrosis, in line with existing CMR–pathology correlations. High-Edema/Low-TnT represented predominantly inflammatory injury with transient dysfunction, whereas Low-Edema/High-TnT corresponded to a necrotic-dominant mismatch with minimal structural involvement. The Low-Edema/Low-TnT phenotype aligned with mild or resolving myocarditis. These findings highlight that edema and troponin capture complementary injury pathways.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"> A simple edema–troponin classification identifies clinically relevant myocarditis phenotypes with distinct biological, structural and functional profiles, offering a practical tool to refine early risk assessment.</span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site