الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Inflammatory heart diseases are still existing important health care issue specially in developing countries, they may cause severe cardiovascular affectation that may reach to myocardial ischemia secondary to coronary arteries affection as seen in Kawasaki disease or need for heart transplantation or assisted devices as in cases of viral myocarditis with subsequent dilated cardiomyopathy. This multiparametric study was performed to study myocardial and vascular involvement in these pediatric inflammatory heart diseases. We hypothesized that cardiac magnetic resonance imaging would provide detailed and precise description of tissue characterization and vascular affection in these diseases. 66 patients diagnosed as inflammatory heart diseases divided into three groups (Rheumatic Heart Disease (RHD) ,Kawasaki Disease (KD) or viral myocarditis) and 14 healthy controls of similar age and sex underwent multiparametric CMR (including cine imaging ,T1 MAP (MOLLI native), T2 MAP, PSIR -LGE, Velocity Encoded Phase Contrast (Aortic and Pulmonary) and T1 MAP (MOLLI post contrast)), in addition to adenosine stress test. CMR was performed at 6 weeks to 6 months after the onset of rheumatic carditis or Kawasaki disease, and 6 weeks after viral myocarditis. Strain was measured on cine images using tissue tracking (CVI 42, v 5.11.2, Circle Cardiovascular Imaging, Calgary, CA). To Our knowledge, it is the largest study that includes multiparametric assessment in inflammatory heart disease in pediatric patients. It studied application of T1, T2 mapping and gadolinium enhancement in tissue characterization in addition to tissue tracking strains for detection of early myocardial deformation. It also studied role of phase contrast CMR in rheumatoid heart disease with mitral valve regurgitation and its correlation with Doppler echocardiography and tissue tracking strains. In all patients with inflammatory heart diseases, Global T2, Native T1, ECV and global left ventricular tissue strains ( longitudinal (GLS) and circumferential (GCS) in addition to radial (GRS) in viral myocarditis group) were found to be significantly affected in comparison to the control group. In RHD, all strain values were correlated with mitral regurgitation fraction. In addition, left ventricular GLS was significantly lower in RHD patients admitted with heart failure than those without. In KD patients, left ventricular GLS was significantly lower in those that had refractory course than those with standard course. Finally, in KD patients, there were 4 cases of subendocardial LGE, 3 cases of subepicardial LGE , 2 cases of coronary LGE and one case of transmural LGE, while, in RHD , there were 3 subepicardial LGE and one subendocardial LGE. Myocarditis patients showed 6 cases of subepicardial LGE, 5 cases of subendocardial LGE and 2 cases of transmural LGE.