DISCUSSION
This study seeks to examine the evidence for the utility of 2D and 3D
echocardiographic parameters of cardiac chamber size and systolic
function in differentiating between adult patients with acute
myocarditis and controls. Our study identified three echocardiographic
parameters (LVEDD, LVEF and LV-GLS) to be useful in the differentiation
between myocarditis and control populations, but with different overall
effect sizes. This study also highlights the application and value of
echocardiography as first line imaging in the clinical setting for
differentiation of patients with acute- and sub-acute phases of
myocarditis. As this disease entity manifests in a heterogeneous manner,
with a known preponderance to LV impairment (due to greater quantity of
myocardium), assessment of the LV systolic function may provide greater
sensitivity to clinical and subclinical changes to the myocardium.
Patients presenting with myocarditis, both acute and recurrent,
typically undergo echocardiography for an initial assessment of
ventricular size and function, along with assessment of regional
wall-motion abnormalities (18).More sensitive measures of LV systolic function such as LV-GLS have been
found to be useful in several cardiac pathologies, both for diagnosis
and prognostication. Similarly, these measures have also demonstrated
the greatest ability to identify earlier phenotypes of myocarditis,
especially those where baseline LV systolic function is preserved