Use of cardiac MR imaging to evaluate the presence of myocarditis in autoimmune myositis: three cases

Springer Science and Business Media LLC - Tập 32 - Trang 779-782 - 2010
Catherine Toong1,2, Rajesh Puranik1,2, Stephen Adelstein1,2
1Royal Prince Alfred Hospital, Camperdown, Australia
2Sydney Medical School, University of Sydney, Sydney, Australia

Tóm tắt

Cardiac involvement in patients with idiopathic inflammatory myopathies (autoimmune myositis) is important to detect because it confers an increased risk of mortality. However, detection of myocardial involvement is hampered by a lack of sensitivity of traditional non-invasive methods, and the finding of elevated cardiac troponin T levels that may be due to regenerating skeletal muscle, rather than myocardial damage. Here, we describe three cases of inflammatory myositis with elevated troponin T levels, and non-specific echocardiographic and ECG findings. Cardiac MR imaging was useful in the evaluation for the presence of myocarditis or alternative cardiac pathology.

Tài liệu tham khảo

Danko K, Ponyi A, Constantin T, Borgulya G, Szegedi G (2004) Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine (Baltimore) 83:35–42 Lundberg IE (2006) The heart in dermatomyositis and polymositis. Rheumatology (Oxford) 45:iv18–iv21 Taylor AJ, Wortham DC, Burge JR, Rogan KM (1993) The heart in polymyositis: a prospective evaluation of 26 patients. Clin Cardiol 16:802–808 Stern R, Godbold JH, Chess Q, Kagen LJ (1984) ECG abnormalities in polymyositis. Arch Intern Med 144:2185–2189 Gottdiener JS, Sherber HS, Hawley RJ, Engel WK (1978) Cardiac manifestations in polymyositis. Am J Cardiol 41:1141–1149 Erlacher P, Lercher A, Falkensammer J, Nassonov E, Samsonov MI, Shtutman V, Puschendorf B, Mair J (2001) Cardiac troponin and β-type myosin heavy chain concentrations in patients with polymyositis or dermatomyositis. Clinica Chimica Acta 306:27–33 Ricchiuti V, Apple FS (1999) RNA expression of cardiac troponin T isoforms in diseased human skeletal muscle. Clin Chem 45:2129–2135 Bodor GS, Survant L, Voss EM, Smith S, Porterfield D, Apple FS (1997) Cardiac troponin T composition in normal and regenerating human skeletal muscle. Clin Chem 43:476–484 Haupt HM, Hutchins GM (1982) The heart and cardiac conduction system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients. Am J Cardiol 50:998–1006 Denbow CE, Lie JT, Tancredi RG, Bunch TW (1979) Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum 22:1088–1092 Ohata S, Shimada T, Shimizu H, Murakami Y (2002) Myocarditis associated with polymyositis diagnosed by gadolinium-DTPA enhanced magnetic resonance imaging. J Rheumatol 29:861–862 Abu-Soud HM, Hazen SL (2000) Nitric oxide is a physiological substrate for mammalian peroxidases. J Biol Chem 275:37524–37532 McCrohon JA, Moon JCC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJS, Pennell DJ (2003) Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 108:54–59