Post-myocardial infarction pericarditis: insight from a cardiovascular magnetic resonance study

Cau, Riccardo;Natale, Luigi;Cademartiri, Filippo;Falconi, Giuseppe;Suri, Jasjit S;Esposito, Antonio;Saba, Luca

2026-01-01

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Abstract

Objective: This study aims to investigate the demographic, laboratory, clinical, and cardiovascular magnetic resonance (CMR) correlates of post-myocardial infarction pericarditis (PMIP), as well as its impact on outcomes in patients with ST-segment elevation myocardial infarction (STEMI) Method: This retrospective study included CMR scans of 122 consecutive patients with STEMI (92 males, mean age 64.16 symbolscript 10.35 years). Among them, 33 (26 males, mean age 60.81 symbolscript 11.27 years) exhibited PMIP, defined by the presence of pericardial enhancement on T2-STIR and/or late gadolinium enhancement (LGE) sequences. Results: Patients with PMIP had a lower left ventricular ejection fraction (p symbolscript 0.017) and a higher indexed right ventricular end-systolic volume (p symbolscript 0.025) compared to those without PMIP. Patients with PMIP exhibited more impaired atrial reservoir strain, global radial strain, and global longitudinal strain, as well as a greater extent of LGE and papillary muscle involvement compared to those without PMIP (p symbolscript 0.001; p symbolscript 0.002; p symbolscript 0.012; p symbolscript 0.001; p symbolscript 0.001, respectively). On multivariate analysis, atrial reservoir strain and global longitudinal strain were independently associated with PMIP ((3 symbolscript-2.803, p symbolscript 0.009; (3 symbolscript 2.475, p symbolscript 0.013). However, the presence of PMIP was not associated with a higher incidence of adverse cardiac events during follow-up. Conclusion: PMIP is a well-known complications of STEMI patients and is associated with greater cardiac dysfunction, as well as more extensive myocardial damage. Despite these myocardial alterations, PMIP did not result in a higher incidence of adverse cardiac events during follow-up.