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>All patients had an abnormal cardiac MRI, with edema and/or LGE in addition to clinical symptoms and troponin elevation, and some had abnormal ECG or echocardiogram.
>The presence of LGE is an indicator of cardiac injury and fibrosis and has been strongly associated with worse prognosis in patients with classical acute myocarditis. In a meta-analysis including 8 studies, Yang et al5 found that presence of LGE is a predictor of all cause death, cardiovascular death, cardiac transplant, rehospitalization, recurrent acute myocarditis, and requirement for mechanical circulatory support. Similarly, Georgiopoulos et al8 found the presence and extent of LGE to be a significant predictor of adverse cardiac outcomes in an 11 study meta-analysis.
https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext