RT Journal Article SR Electronic T1 Quantitative assessment of pericardial delayed hyperenhancement helps identify patients with ongoing recurrences of pericarditis JF Open Heart JO Open Heart FD British Cardiovascular Society SP e000944 DO 10.1136/openhrt-2018-000944 VO 5 IS 2 A1 Arnav Kumar A1 Kimi Sato A1 Beni Rai Verma A1 Chandra Kanth Ala A1 Jorge Betancor A1 Edlira Yzeiraj A1 Lin Lin A1 Divyanshu Mohananey A1 Salima Qamruddin A1 Apostolos Kontzias A1 Michael A Bolen A1 Massimo M Imazio A1 Deborah H Kwon A1 Rory Hachamovitch A1 Allan L Klein YR 2018 UL http://openheart.bmj.com/content/5/2/e000944.abstract AB Objectives Recurrences of pericarditis (RP) are often difficult to diagnose due to lack of clinical signs and symptoms during subsequent episodes. We aimed to investigate the value of quantitative assessment of pericardial delayed hyperenhancement (DHE) in diagnosing ongoing recurrences of pericarditis.Methods Quantitative DHE was measured in 200 patients with established diagnosis of RP using cardiac MRI. Conventional clinical criteria for diagnosis of pericarditis were ≥2 of the following: chest pain, pericardial rub, ECG changes and new or worsening pericardial effusion.Results A total of 67 (34%) patients were identified as having ongoing episode of recurrence at the time of DHE measurements. In multivariable analysis, chest pain (OR: 10.9, p<0.001) and higher DHE (OR: 1.32, p<0.001) were associated with ongoing recurrence of RP. Addition of DHE to conventional clinical criteria significantly increased the ability to diagnose ongoing recurrence (net reclassification improvement (NRI): 0.80, p<0.001; integrated discrimination improvement (IDI): 0.12, p<0.001). Among 150 patients with history of RP who presented with chest pain, higher DHE was still independently associated with ongoing recurrence (OR: 1.28, p<0.001), showed incremental value over clinical criteria (NRI: 0.76, p<0.001; IDI: 0.13, p<0.001) and demonstrated a sensitivity of 70% and specificity of 74%.Conclusion Among patients with RP, quantitative DHE provided incremental information to diagnose ongoing recurrences over conventional clinical criteria of pericarditis. Quantitative DHE demonstrated acceptable test characteristics to diagnose ongoing recurrence even in RP patients presenting with chest pain.