CMR Late Enhancement Pericarditis Index (LEPI) Calculator

CMR Late Enhancement Pericarditis Index (LEPI): Explanation and Clinical Context
The CMR LEPI is a quantitative tool developed to assess the severity and risk stratification in patients with acute or chronic pericarditis using cardiac magnetic resonance imaging.
It integrates three key parameters: pericardial late gadolinium enhancement (LGE) score, pericardial thickness measured on imaging, and pericardial edema detected by T2-weighted sequences.
The formula, as proposed in original studies, weights LGE most heavily, followed by thickness and edema: LEPI = (LGE × 0.5) + (Thickness × 0.3) + (Edema × 0.2).
A higher LEPI score correlates with increased risk of adverse outcomes, including recurrent pericarditis, constrictive physiology, or need for escalated anti-inflammatory therapy.
This index allows clinicians to objectively quantify disease activity and guide management, especially when traditional clinical assessment is equivocal.

Reference:
Aquaro GD, et al. JACC Cardiovasc Imaging. 2021;14(3):567-579. doi:10.1016/j.jcmg.2020.09.016