Acute myocarditis with autoimmune features: one-year follow-up with CMR
Tóm tắt
In this prospective study on patients with acute myocarditis (AM), we aimed to describe the new concept of AMAF (AM with autoimmune features) similar to the previously described interstitial pneumonia with autoimmune features (IPAF). IPAF has recently emerged as a new entity, and IPAF patients appear to have fewer episodes of exacerbation and better survival than patients with idiopathic pulmonary fibrosis. Consecutive patients with infarct-like CMR-confirmed AM were classified AMAF if their serologic status measured from blood sampled at presentation was positive (antinuclear antibodies (ANA) ≥ 1:320), but without meeting established classification criteria for connective tissue disease (CTD). The myocardial tissue abnormalities and their progression were assessed on cardiac magnetic resonance (CMR) within 7 days following symptom onset and at 1 year according to their seropositivity. Among the 64 AM patients included, seven presented AMAF (11%). At baseline CMR, patients with AMAF had half as much late gadolinium enhancement (LGE) as seronegative AM patients (4.41% (1.47–4.41) of myocardial volume versus 8.82% (5.88–14.71), p = 0.01, respectively). At 1-year of follow-up, persistent myocardial scarring was less frequent in AMAF patients (n = 2 (28.6%) than seronegative AM patients (n = 38 (66.7%) (p = 0.021). AMAF, diagnosed as seropositive AM without a specific autoimmune disease, is not rare and is associated with less extensive LGE in the acute phase. In addition, AMAF patients had more favorable outcomes on 12-month CMR. Prospective studies are needed to address the clinical significance of this new concept and its long-term cardiovascular impact.
Tài liệu tham khảo
Caforio ALP, Marcolongo R, Basso C, Iliceto S (2015) Clinical presentation and diagnosis of myocarditis. Heart 101:1332–1344
Cooper LT (2009) Myocarditis. N Engl J Med 360:1526–1538
Caforio AL, Pankuweit S, Arbustini S, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Helio T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron A, Elliott PM (2013) European Society of Cardiology Working Group on Myocardial and Pericardial Diseases, 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. Eur Heart J 34:2636–2648
Mahrholdt H, Wagner A, Deluigi CC, Kispert E, Hager S, Meinhardt G, Vogelsberg H, Fitz P, Dippon J, Bock C-T, Kingel K, Kandolf R, Sechtem U (2006) Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation 114:1581–2190
Eckart RE, Scoville SL, Campbell CL, Shru EA, Stajduhar KC, Potter RN, Pearse LA, Virmani R (2004) Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 141:829–834
Kasper EK, Agema WR, Hutchins GM, Deckers JW, Hare JM, Baughman KL (1994) The causes of dilated cardiomyopathy: a clinicopathologic review of 673 consecutive patients. J Am Coll Cardiol 23:586–590
Gräni C, Eichhorn C, Bière L, Agarwal V, Kaneko K, Cuddy S, Aghayev A, Steigner M, Blankstein R, Jerosch-Herold M, Kwong RY (2017) Prognostic value of cardiac magnetic resonance tissue characterization in risk stratifying patients with suspected myocarditis. J Am Coll Cardiol 70:1964–1976
Aquaro GD, Ghebru Habtemicael Y, Camastra G, Monti L, Dellegrottaglie S, Moro C, Lanzillo C, Scatteia A, Di Roma M, Pontone G, Perazzolo Marra M, Barison A, Di Bella G (2019) “Cardiac Magnetic Resonance” Working Group of the Italian Society of Cardiology, Prognostic value of repeating cardiac magnetic resonance in patients with acute myocarditis. J Am Coll Cardiol 74:2439–2448
Sambataro G, Sambataro D, Torrisi SS, Vancheri A, Pavone M, Rosso R, Schisano M, Crimi C, Pignataro F, Fischer A, Del Papa N, Vancheri C (2018) State of the art in interstitial pneumonia with autoimmune features: a systematic review on retrospective studies and suggestions for further advances. Eur Respir Rev 27:170139
Lee CT, Oldham JM (2017) Interstitial pneumonia with autoimmune features: overview of proposed criteria and recent cohort characterization. Clin Pulm Med 24:191–196
Oldham JM, Adegunsoye A, Valenzi E, Lee C, Witt L, Chen L, Husain AN, Montner S, Chung JH, Cottin V, Fischer A, Noth I, Vij R, Strek ME (2016) Characterisation of patients with interstitial pneumonia with autoimmune features. Eur Respir J 47:1767–1775
Chartrand S, Swigris JJ, Stanchev L, Lee JS, Brown KK, Fischer A (2016) Clinical features and natural history of interstitial pneumonia with autoimmune features: a single center experience. Respir Med 119:150–154
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Norman FJF, Cooper NS, Healay LA, Kaplan SR, Laing MH, Luthra HS, Medsger TA, Michell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324
Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347
Masi AT (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma) Subcommittee for scleroderma criteria of the American rheumatism association diagnostic and therapeutic criteria committee. Arthritis Rheum 23:581–590
Tan EM, Cohen AS, Fries JF, Masi AT, Mc Shane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277
Shiboski SC, Shiboski CH, Criswell L, Baer AN, Challacombe S, Lanfranchi H, Schiedt M, Umehara H, Vivino F, Zhao Y, Dong Y, Greenspan D, Heidenriech AM, Helin P, Kirkham B, Kitagawa K, Larkin G, Li M, Lietman T, Lindegaard J, McNamara N, Sack K, Shirlaw P, Sugai S, Vollenweider C, Whitcher J, Wu A, Zhang S, Zhang W, Greenspan JS, Daniels TE (2012) Sjogren’s international collaborative clinical Alliance research G, American College of rheumatology classification criteria for Sjogren’s syndrome: a data-driven, expert consensus approach in the Sjogren’s international collaborative clinical Alliance cohort. Arthritis Care Res (Hoboken) 64:475–487
Alarcon-Segovia D (1994) Mixed connective tissue disease and overlap syndromes. Clin Dermatol 12:309–316
Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, Hagen EC, Hoffman GS, Hunder GG, Kallenderg CG, McCluskey RT, Sinico A, Rees AJ, van Es LA, Waldherr R, Wiik A (1994) Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum 37:187–192
Yoshimura K, Kono M, Enomoto Y, Nishimoto K, Oyama Y, Yasui H, Hozumi H, Karayama M, Suzuki Y, Furuhashi K, Enomoto N, Fujisawa T, Nakamura Y, Inui N, Sumikawa H, Johkoh T, Colby TV, Sugimura H, Suda T (2018) Distinctive characteristics and prognostic significance of interstitial pneumonia with autoimmune features in patients with chronic fibrosing interstitial pneumonia. Respir Med 137:167–175
Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, White JA, Abdel-Aty H, Gutberlet M, Prasad S, Aletras A, Laissy JP, Paterson I, Filipchuk NG, Kumar A, Pauschinger M, Liuet P (2009) International consensus group on cardiovascular magnetic resonance in myocarditis, cardiovascular magnetic resonance in myocarditis: a JACC white paper. J Am Coll Cardiol 53:1475–1487
Abdel-Aty H, Boyé P, Zagrosek A, Wassmuth R, Kumar A, Messroghli D, Bock P, Dietz R, Friedrich MG, Schulz-Menger J (2005) Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol 45:1815–1822
Bossuyt X, De Langhe E, Borghi MR, Meroni PL (2020) Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases. Nat Rev Rheumatol 16:715–726
Pineton de Chambrun M, Charuel JL, Hekimian G, Lifermann F, Mathian A, Cohen-Aubart F, Melki I, Luyt CE, Combes A, Amoura Z (2020) Severe viral myopericarditis with autoantibodies directed against RNA polymerase III. Ann Intern Med 172:502–504
Chopra H, Arangalage D, Bouleti C, Zarka S, Fayard F, Chillon S, Laissy JP, Henry-Feugeas MC, Steg PG, Vahanian A, Ou P (2016) Prognostic value of the infarct- and non-infarct like patterns and cardiovascular magnetic resonance parameters on long-term outcome of patients after acute myocarditis. Int J Cardiol 212:63–69
Al C, Calabrese F, Angelini A, Tona F, Vinci A, Bottaro S, Ramondo A, Carturan E, Iliceto S, Thiene G, Daliento L (2007) A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Eur Heart J 28:1326–1333
Grün S, Schumm J, Greulich S, Wagner A, Schneider S, Bruder O, Kispert EM, Hill S, Ong P, Klingel K, Kandolf R, Sechtem U, Mahrholdt H (2012) Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery. J Am Coll Cardiol 59:1604–1615
Peretto G, Sala S, De Luca G, Campochiaro C, Sartorelli S, Cappelletti AM, Rizzo S, Palmisano A, Esposito A, Margonato A, Tresoldi M, Thiene G, Basso C, Dagna L, Della Bella P (2019) Impact of systemic immune-mediated diseases on clinical features and prognosis of patients with biopsy-proved myocarditis. Int J Cardiol 280:110–116
Selmi C, Ceribelli A, Generali E, Scire CA, Alborghetti F, Colloredo G, Parrati L, Achenza MIS, De Santis M, Cavacioccji F, Massarotti M, Isailovic N, Paleari V, Invernizzi P, Matthias T, Zucchi A, Meroni PL (2016) Serum antinuclear and extractable nuclear antigen antibody prevalence and associated morbidity and mortality in the general population over 15 years. Autoimmun Rev 15:162–166
Zawadowski GM, Klarich KW, Moder KG, Edwards W, Cooper LTJ (2012) A contemporary case series of lupus myocarditis. Lupus 21:1378–1384
Pulerwitz TC, Cappola TP, Felker GM, Hare JM, Baughman KL, Kasper EK (2004) Mortality in primary and secondary myocarditis. Am Heart J 147:746–750
Simpson KE, Cunningham MW, Lee CK, Ward K, Tong A, Danon S, Simon C, Delaney JW, Canter CE (2016) Autoimmunity against the heart and cardiac myosin in children with myocarditis. J Card Fail 22:520–528
Ryabkova VA, Shubik YV, Erman MV, Churilov LP, Kanduc D, Shoenfeld Y (2019) Lethal immunoglobulins: autoantibodies and sudden cardiac death. Autoimmun Rev 18:415–425
Allanore Y, Vignaux O, Arnaud L, Puechal X, Duboc D, Legmann P, Kahan A (2006) Effects of corticosteroids and immunosuppressors on idiopathic inflammatory myopathy related myocarditis evaluated by magnetic resonance imaging. Ann Rheum Dis 65:249–252
Ferreira VM, Schulz-Menger J, Holmvang G, Kramer CM, Carbone I, Sechtem U, Kindermann I, Gutberlet M, Cooper LT, Liu P, Friedrich MG (2018) Cardiovascular magnetic resonance in nonischemic myocardial inflammation. J Am Coll Cardiol 72:3158–3176