Pan-immune-inflammation value: a new predictor of cardiac scar in hospitalized myocarditis patients

Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging indicates myocardial scarring and has prognostic value in myocarditis. The Pan-Immune-Inflammation Value (PIV) is a novel biomarker reflecting systemic inflammation; however, its association with LGE in myocarditis remains uninvestigated. This study aims to evaluate whether PIV levels can predict the presence of LGE in patients with myocarditis. We retrospectively analyzed 141 patients with myocarditis between 2021 and 2024. PIV, troponin levels, and other inflammatory markers were analyzed for their association with LGE. LGE was observed in 68.8% of the patients, with a higher proportion of males in the LGE+ group. The LGE+ group showed significantly elevated levels of PIV (1.661.2 ± 22.269) and troponin (786.2 ± 10.711 ng/L) compared to the LGE− group. Multivariate regression analysis confirmed PIV (OR: 1.002, <i>p</i> = 0.005) and troponin (OR: 1.003, <i>p</i> = 0.001) as predictors of LGE. ROC analysis identified a PIV threshold of &gt;1153.2, achieving 95% specificity with a positive predictive value of 92.9% for LGE presence. Our findings indicate that elevated PIV levels are significant predictors of LGE, suggesting that PIV may serve as a valuable tool in assessing risk and guiding follow-up strategies for patients with myocarditis.