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

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 ± 10.35 years). Among them, 33 (26 males, mean age 60.81 ± 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 = 0.017) and a higher indexed right ventricular end-systolic volume (p = 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 = 0.001; p = 0.002; p = 0.012; p = 0.001; p = 0.001, respectively). On multivariate analysis, atrial reservoir strain and global longitudinal strain were independently associated with PMIP (β = -2.803, p = 0.009; β = 2.475, p = 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.