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Clinical Rheumatology

, Volume 38, Issue 12, pp 3471–3476 | Cite as

Cardiac involvement in idiopathic inflammatory myopathies detected by cardiac magnetic resonance imaging

  • Thomas KhooEmail author
  • Michael B. Stokes
  • Karen Teo
  • Susanna Proudman
  • Sajini Basnayake
  • Prashanthan Sanders
  • Vidya Limaye
Brief Report

Abstract

Cardiac involvement in idiopathic inflammatory myopathies (IIM) adversely affects prognosis but is commonly sub-clinical. Cardiac magnetic resonance imaging (CMR) is an effective imaging modality for detecting myocardial inflammation and fibrosis but its use as a screening tool for cardiac disease in IIM has not been fully explored. Nineteen patients with IIM without cardiac symptoms underwent CMR using a specific cardiomyopathy protocol including specific sequences detecting focal and diffuse myocardial fibrosis. 9/19 patients demonstrated late gadolinium enhancement (LGE (3/9 right ventricular insertion, 1/9 sub-endocardial, 7/9 mid-wall/sub-epicardial)). T1 mapping was performed in 15 patients. In total, 7/15 had elevated native T1 values, of which four had detected LGE. Myocardial fibrosis was frequently detected in IIM patients without cardiac history. Detection of LGE and elevated T1 values may have negative prognostic implications. Longitudinal studies determining whether early or augmented treatment has a role in patients with sub-clinical cardiac involvement are needed.

Key Points

Cardiac involvement in myositis adversely affects prognosis.

Cardiac magnetic resonance imaging is an effective tool for detecting cardiac involvement.

T1 mapping is a technique which detects diffuse myocardial inflammation and fibrosis.

In our study, focal and diffuse myocardial fibrosis was frequently found in myositis patients without cardiac symptoms.

Keywords

Cardiac magnetic resonance imaging Cardiomyopathy Heart failure Idiopathic inflammatory myopathy Myocardial fibrosis Myocarditis 

Notes

Acknowledgements

This research did not receive any specific grants from funding agencies in the public, commercial or not-for-profit sectors. All patient identifiers or details that may disclose the identity of patients have been removed. This was performed in accordance with the ethical standards laid down in the 1964 declaration of Helsinki and its later amendments.

Compliance with ethical standards

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Central Adelaide Local Health NetworkAdelaideAustralia
  2. 2.Department of CardiologyCentral Adelaide Local Health NetworkAdelaideAustralia
  3. 3.Centre for Heart Rhythm Disorders, South Australian Health and Medical Research InstituteUniversity of AdelaideAdelaideAustralia
  4. 4.Rheumatology UnitRoyal Adelaide HospitalAdelaideAustralia
  5. 5.Discipline of MedicineUniversity of AdelaideAdelaideAustralia
  6. 6.Rheumatology SAAdelaideAustralia

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