MRI-VERIFIED MYOCARDITIS WITH VARIABLE GRADES OF CARDIAC REMODELING: ANALYSIS OF TWO CLINICAL CASES

Abstract

This article presents two clinical cases of CMR-verified myocarditis with different degrees of cardiac remodeling
and impairment of left ventricular systolic function. A comparative analysis of clinical manifestations, laboratory findings, and
instrumental data was performed in accordance with the current recommendations of the European Society of Cardiology (ESC,
2025).
In the first case, pronounced myocardial remodeling with a significant reduction in left ventricular ejection fraction and the
presence of late gadolinium enhancement consistent with post-inflammatory myocardial fibrosis were observed. The second
case was characterized by a chronic course of myocarditis with moderate remodeling and less pronounced systolic dysfunction.
The presented clinical cases illustrate the heterogeneity of myocarditis progression and emphasize the diagnostic value of
cardiac MRI in detecting inflammation, fibrosis, and assessing prognosis. In addition, speckle-tracking echocardiography may be
considered a promising method for the early detection of subclinical myocardial dysfunction and risk stratification in patients
with myocarditis.