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Published in: Rheumatology International 3/2012

01-03-2012 | Case Report

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

Authors: Catherine Toong, Rajesh Puranik, Stephen Adelstein

Published in: Rheumatology International | Issue 3/2012

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Abstract

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.
Literature
1.
go back to reference 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) 83:35–42CrossRef 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) 83:35–42CrossRef
2.
go back to reference Lundberg IE (2006) The heart in dermatomyositis and polymositis. Rheumatology (Oxford) 45:iv18–iv21CrossRef Lundberg IE (2006) The heart in dermatomyositis and polymositis. Rheumatology (Oxford) 45:iv18–iv21CrossRef
3.
go back to reference Taylor AJ, Wortham DC, Burge JR, Rogan KM (1993) The heart in polymyositis: a prospective evaluation of 26 patients. Clin Cardiol 16:802–808PubMedCrossRef Taylor AJ, Wortham DC, Burge JR, Rogan KM (1993) The heart in polymyositis: a prospective evaluation of 26 patients. Clin Cardiol 16:802–808PubMedCrossRef
4.
go back to reference Stern R, Godbold JH, Chess Q, Kagen LJ (1984) ECG abnormalities in polymyositis. Arch Intern Med 144:2185–2189PubMedCrossRef Stern R, Godbold JH, Chess Q, Kagen LJ (1984) ECG abnormalities in polymyositis. Arch Intern Med 144:2185–2189PubMedCrossRef
5.
go back to reference Gottdiener JS, Sherber HS, Hawley RJ, Engel WK (1978) Cardiac manifestations in polymyositis. Am J Cardiol 41:1141–1149PubMedCrossRef Gottdiener JS, Sherber HS, Hawley RJ, Engel WK (1978) Cardiac manifestations in polymyositis. Am J Cardiol 41:1141–1149PubMedCrossRef
6.
go back to reference 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 306:27–33CrossRef 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 306:27–33CrossRef
7.
go back to reference Ricchiuti V, Apple FS (1999) RNA expression of cardiac troponin T isoforms in diseased human skeletal muscle. Clin Chem 45:2129–2135PubMed Ricchiuti V, Apple FS (1999) RNA expression of cardiac troponin T isoforms in diseased human skeletal muscle. Clin Chem 45:2129–2135PubMed
8.
go back to reference 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 43:476–484PubMed 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 43:476–484PubMed
9.
go back to reference Haupt HM, Hutchins GM (1982) The heart and cardiac conduction system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients. Am J Cardiol 50:998–1006PubMedCrossRef Haupt HM, Hutchins GM (1982) The heart and cardiac conduction system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients. Am J Cardiol 50:998–1006PubMedCrossRef
10.
go back to reference Denbow CE, Lie JT, Tancredi RG, Bunch TW (1979) Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum 22:1088–1092PubMedCrossRef Denbow CE, Lie JT, Tancredi RG, Bunch TW (1979) Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum 22:1088–1092PubMedCrossRef
11.
go back to reference Ohata S, Shimada T, Shimizu H, Murakami Y (2002) Myocarditis associated with polymyositis diagnosed by gadolinium-DTPA enhanced magnetic resonance imaging. J Rheumatol 29:861–862PubMed Ohata S, Shimada T, Shimizu H, Murakami Y (2002) Myocarditis associated with polymyositis diagnosed by gadolinium-DTPA enhanced magnetic resonance imaging. J Rheumatol 29:861–862PubMed
12.
go back to reference Abu-Soud HM, Hazen SL (2000) Nitric oxide is a physiological substrate for mammalian peroxidases. J Biol Chem 275:37524–37532PubMedCrossRef Abu-Soud HM, Hazen SL (2000) Nitric oxide is a physiological substrate for mammalian peroxidases. J Biol Chem 275:37524–37532PubMedCrossRef
13.
go back to reference 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 108:54–59PubMedCrossRef 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 108:54–59PubMedCrossRef
Metadata
Title
Use of cardiac MR imaging to evaluate the presence of myocarditis in autoimmune myositis: three cases
Authors
Catherine Toong
Rajesh Puranik
Stephen Adelstein
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 3/2012
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-009-1324-6

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