In this position statement of the ESC Working Group on Myocardial and Pericardial Diseases an expert consensus group reviews the current knowledge on clinical presentation, diagnosis and treatment of myocarditis, and proposes new diagnostic criteria for clinically suspected myocarditis and its distinct biopsy-proven pathogenetic forms. The aims are to bridge the gap between clinical and tissue-based diagnosis, to improve management and provide a common reference point for future registries and multicentre randomised controlled trials of aetiology-driven treatment in inflammatory heart muscle disease.

/pdf/current-state-of-knowledge-on-aetiology-diagnosis-management-1cmcstpgnt.pdf

Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases.

Cardiovascular Magnetic Resonance in Myocarditis: A JACC White Paper

Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations.

This document was developed by the American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents (ECDs) and cosponsored by the American College of Radiology (ACR), American Heart Association (AHA), North American Society for Cardiovascular Imaging (NASCI), and

ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents

Expert Consensus DocumentACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance: A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents

Purpose: To retrospectively compare the diagnostic accuracy of three cardiac magnetic resonance (MR) imaging approaches for the detection of histologic and immunohistologic criteria (reference standard) proved myocardial inflammation in patients clinically suspected of having chronic myocarditis (CMC). Materials and Methods: Cardiac MR imaging was performed in 83 consecutive patients (55 male, 28 female; mean age, 44.8 years ± 17.7 [standard deviation]) clinically suspected of having CMC, after written informed consent was obtained according to guidelines of the local ethics committee, which approved the study. T2-weighted triple-inversion-recovery imaging to calculate the edema ratio (ER), T1-weighted imaging before and after contrast agent administration to calculate the myocardial global relative enhancement (gRE), and inversion-recovery gradient-echo imaging to evaluate areas of late gadolinium enhancement (LE) were performed. The MR results were correlated with the endomyocardial biopsy (EMB) finding...

Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence.

In this article, we present the port-Hamiltonian representation, the structure preserving discretization and the resulting finite-dimensional state space model of one-dimensional filaments based on a mixed finite element formulation. Due to the fact that the equations of motion of a filamentous body are based on the theory of geometrically nonlinear mechanical systems, the port-Hamiltonian formulation is expressed by means of its co-energy (effort) variables. The resulting port-Hamiltonian state space model features a quadratic Hamiltonian and the nonlinearity is reflected in the state dependence of its interconnection matrix. Numerical experiments generated with FEniCS illustrate the properties of the resulting finite element models. 

Port-Hamiltonian FE models for filaments

In this article, we present the port-Hamiltonian representation, the structure preserving discretization and the resulting finitedimensional state space model of geometrically nonlinear mechanical systems based on a mixed finite element formulation. This article focuses on St. Venant–Kirchhoff materials connecting the Green strain and the second Piola-Kirchhoff stress tensor in a linear relationship which allows a port-Hamiltonian representation by means of its co-energy (effort) variables. Due to treatment of both Dirichlet and Neumann boundary conditions in the appropriate variational formulation, the resulting port-Hamiltonian state space model features both of them as explicit (control) inputs. Numerical experiments generated with FEniCS illustrate the properties of the resulting FE models.

Explicit port-Hamiltonian FEM models for geometrically nonlinear mechanical systems

Port-Hamiltonian (PH) systems provide a framework for modeling, analysis and control of complex dynamical systems, where the complexity might result from multi-physical couplings, non-trivial domains and diverse nonlinearities. A major benefit of the PH representation is the explicit formulation of power interfaces, so-called ports, which allow for a power-preserving interconnection of subsystems to compose flexible multibody systems in a modular way. In this work, we present a PH representation of geometrically exact strings with nonlinear material behaviour. Furthermore, using structure-preserving discretization techniques a corresponding finite-dimensional PH state space model is developed. Applying mixed finite elements, the semi-discrete model retains the PH structure and the ports (pairs of velocities and forces) on the discrete level. Moreover, discrete derivatives are used in order to obtain an energy-consistent time-stepping method. The numerical properties of the newly devised model are investigated in a representative example. The developed PH state space model can be used for structure-preserving simulation and model order reduction as well as feedforward and feedback control design.

Port-Hamiltonian formulation and structure-preserving discretization of hyperelastic strings

We provide a fully nonlinear port-Hamiltonian formulation for discrete elastodynamical systems as well as a structure-preserving time discretization. The governing equations are obtained in a variational manner and represent index-1 differential algebraic equations. Performing an index reduction one obtains the port-Hamiltonian state space model, which features the nonlinear strains as an independent state next to position and velocity. Moreover, hyperelastic material behavior is captured in terms of a nonlinear stored energy function. The model exhibits passivity and losslessness and has an underlying symmetry yielding the conservation of angular momentum. We perform temporal discretization using the midpoint discrete gradient, such that the beneficial properties are inherited by the developed time stepping scheme in a discrete sense. The numerical results obtained in a representative example are demonstrated to validate the findings.

Tobias Thoma

Papers

Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence.

Port-Hamiltonian FE models for filaments

Explicit port-Hamiltonian FEM models for geometrically nonlinear mechanical systems

Port-Hamiltonian formulation and structure-preserving discretization of hyperelastic strings

Discrete nonlinear elastodynamics in a port-Hamiltonian framework