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Open Access 01-03-2010 | Original Communication

The heart in sporadic inclusion body myositis: a study in 51 patients

Authors: Fieke M. Cox, Victoria Delgado, Jan J. Verschuuren, Bart E. Ballieux, Jeroen J. Bax, Axel R. Wintzen, Umesh A. Badrising

Published in: Journal of Neurology | Issue 3/2010

Abstract

The purpose of this study was to explore the prevalence and nature of cardiac abnormalities in sporadic inclusion body myositis (sIBM). Fifty-one sIBM patients were cross-sectionally studied using history-taking, physical examination, measurements of serum creatine kinase activity, the MB fraction (CK-MB), cardiac troponin T (cTnT) and I (cTnI), a 12-lead electrocardiogram (ECG) and 2-dimensional echocardiography. Present cardiac history was abnormal in 12 (24%) out of 51 patients, 12 (24%) patients had abnormalities on ECG, mostly aspecific, and in 12 (24%) patients the echocardiograph showed abnormalities. Elevated CK-MB was present in 42 (82%) patients and 40 (78%) had an elevated cTnT in the absence of acute cardiac pathology. In contrast, in one patient (2%) cTnI was elevated. There was no apparent association between elevated biomarkers, ECG or echocardiographic abnormalities. The prevalence of cardiac abnormalities in sIBM does not seem to be higher than would be expected in these elderly patients. Elevated CK-MB and cTnT levels are common, in contrast to cTnI, but do not reflect cardiac pathology.

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Ammann P, Pfisterer M, Fehr T, Rickli H (2004) Raised cardiac troponins. BMJ 328:1028–1029CrossRefPubMed

Ashley EA, Raxwal V, Froelicher V (2001) An evidence-based review of the resting electrocardiogram as a screening technique for heart disease. Prog Cardiovasc Dis 44:55–67CrossRefPubMed

Badrising UA, Maat-Schieman M, van Duinen SG, Breedveld F, van Doorn P, van Engelen B, van den HF, Hoogendijk J, Howeler C, de Jager A, Jennekens F, Koehler P, van der LH, de Visser M, Verschuuren JJ, Wintzen AR (2000) Epidemiology of inclusion body myositis in the Netherlands: a nationwide study. Neurology 55:1385–1387PubMed

Badrising UA, Maat-Schieman ML, van Houwelingen JC, van Doorn PA, van Duinen SG, van Engelen BG, Faber CG, Hoogendijk JE, de Jager AE, Koehler PJ, de Visser M, Verschuuren JJ, Wintzen AR (2005) Inclusion body myositis. Clinical features and clinical course of the disease in 64 patients. J Neurol 252:1448–1454CrossRefPubMed

Bazett HC (1920) An analysis of time-relations of electrocardiograms. Heart 7:353–370

Bodor GS, Porterfield D, Voss EM, Smith S, Apple FS (1995) Cardiac troponin-I is not expressed in fetal and healthy or diseased adult human skeletal muscle tissue. Clin Chem 41:1710–1715PubMed

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

Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347PubMedCrossRef

Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407PubMed

10.

Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458CrossRefPubMed

11.

Eriksson P, Hansson PO, Eriksson H, Dellborg M (1998) Bundle-branch block in a general male population: the study of men born 1913. Circulation 98:2494–2500PubMed

12.

Erlacher P, Lercher A, Falkensammer J, Nassonov EL, Samsonov MI, Shtutman VZ, Puschendorf B, Mair J (2001) Cardiac troponin and beta-type myosin heavy chain concentrations in patients with polymyositis or dermatomyositis. Clin Chim Acta 306:27–33CrossRefPubMed

13.

Gonzalez-Lopez L, Gamez-Nava JI, Sanchez L, Rosas E, Suarez-Almazor M, Cardona-Munoz C, Ramos-Remus C (1996) Cardiac manifestations in dermato-polymyositis. Clin Exp Rheumatol 14:373–379PubMed

14.

Gottdiener JS, Sherber HS, Hawley RJ, Engel WK (1978) Cardiac manifestations in polymyositis. Am J Cardiol 41:1141–1149CrossRefPubMed

15.

Hamm CW, Goldmann BU, Heeschen C, Kreymann G, Berger J, Meinertz T (1997) Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I. N Engl J Med 337:1648–1653CrossRefPubMed

16.

Hiss RG, Lamb LE (1962) Electrocardiographic findings in 122,043 individuals. Circulation 25:947–961PubMed

17.

Kadish AH, Buxton AE, Kennedy HL, Knight BP, Mason JW, Schuger CD, Tracy CM, Boone AW, Elnicki M, Hirshfeld JW Jr, Lorell BH, Rodgers GP, Tracy CM, Weitz HH (2001) ACC/AHA clinical competence statement on electrocardiography and ambulatory electrocardiography. A report of the ACC/AHA/ACP-ASIM Task Force on Clinical Competence (ACC/AHA Committee to Develop a Clinical Competence Statement on Electrocardiography and Ambulatory Electrocardiography). J Am Coll Cardiol 38:2091–2100CrossRefPubMed

18.

Larca LJ, Coppola JT, Honig S (1981) Creatine kinase MB isoenzyme in dermatomyositis: a noncardiac source. Ann Intern Med 94:341–343PubMed

19.

Lindberg C, Klintberg L, Oldfors A (2006) Raised troponin T in inclusion body myositis is common and serum levels are persistent over time. Neuromuscul Disord 16:495–497CrossRefPubMed

20.

Needham M, James I, Corbett A, Day T, Christiansen F, Phillips B, Mastaglia FL (2008) Sporadic inclusion body myositis: phenotypic variability and influence of HLA-DR3 in a cohort of 57 Australian cases. J Neurol Neurosurg Psychiatry 79:1056–1060

21.

Oka M, Raasakka T (1978) Cardiac involvement in polymyositis. Scand J Rheumatol 7:203–208CrossRefPubMed

22.

Pereira AM, van Thiel SW, Lindner JR, Roelfsema F, van der Wall EE, Morreau H, Smit JW, Romijn JA, Bax JJ (2004) Increased prevalence of regurgitant valvular heart disease in acromegaly. J Clin Endocrinol Metab 89:71–75CrossRefPubMed

23.

Schwarzmeier JD, Hamwi A, Preisel M, Resl C, Preusser M, Sluga E, Horcher E, Shehata MM (2005) Positive troponin T without cardiac involvement in inclusion body myositis. Hum Pathol 36:917–921CrossRefPubMed

24.

Sokolow M, Lyon TP (1949) The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 37:161–186CrossRefPubMed

25.

Stefano G, Fox K, Schluchter M, Hoit BD (2008) Prevalence of unsuspected and significant mitral and aortic regurgitation. J Am Soc Echocardiogr 21:38–42CrossRefPubMed

26.

Stern R, Godbold JH, Chess Q, Kagen LJ (1984) ECG abnormalities in polymyositis. Arch Intern Med 144:2185–2189CrossRefPubMed

27.

van Thiel SW, Bax JJ, Biermasz NR, Holman ER, Poldermans D, Roelfsema F, Lamb HJ, van der Wall EE, Smit JW, Romijn JA, Pereira AM (2005) Persistent diastolic dysfunction despite successful long-term octreotide treatment in acromegaly. Eur J Endocrinol 153:231–238CrossRefPubMed

28.

Verschuuren JJ, Badrising UA, Wintzen AR, Engelen B, van der Hoeven H, Hoogendijk JE (1997) Inclusion Body Myositis. In: Emery A (ed) Diagnostic criteria for neuromuscular disorders. Royal Society of Medicine Press, European Neuromuscular Center, London, pp 81–84

29.

Wu AH, Apple FS, Gibler WB, Jesse RL, Warshaw MM, Valdes R Jr (1999) National Academy of Clinical Biochemistry Standards of Laboratory Practice: recommendations for the use of cardiac markers in coronary artery diseases. Clin Chem 45:1104–1121PubMed

Title: The heart in sporadic inclusion body myositis: a study in 51 patients
Authors: Fieke M. Cox
Victoria Delgado
Jan J. Verschuuren
Bart E. Ballieux
Jeroen J. Bax
Axel R. Wintzen
Umesh A. Badrising
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Journal of Neurology / Issue 3/2010
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-009-5350-9

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The heart in sporadic inclusion body myositis: a study in 51 patients

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