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Cardiovascular Magnetic Resonance Demonstrates Myocardial Inflammation of Differing Etiologies and Acuities in

George Markousis-Mavrogenis1,2, Antonios Belegrinos3, Aikaterini Giannakopoulou4

  • 1Olympic Diagnostic/Research Center, 17674 Athens, Greece.

Journal of Clinical Medicine
|February 25, 2023
PubMed

Insights

Cardiovascular magnetic resonance (CMR) reveals acute myocardial inflammation in most symptomatic inflammatory myopathy patients with normal echocardiography. Genetic myopathies show rare acute inflammation but evidence of chronic changes.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Myopathies are complex neuromuscular disorders affecting cardiac and skeletal muscles.
  • Cardiac involvement is a concern in myopathies, necessitating advanced diagnostic tools.
  • Echocardiography may not detect subtle cardiac changes in myopathy patients.

Purpose of the Study:

  • To investigate the prevalence of cardiac inflammation in myopathy patients with cardiovascular symptoms and normal echocardiography.
  • To utilize cardiovascular magnetic resonance (CMR) for detailed cardiac assessment.
  • To differentiate cardiac inflammation patterns between genetic and inflammatory myopathies.

Main Methods:

  • Prospective evaluation of 51 patients with genetic (n=23) and inflammatory (n=28) myopathies.
  • Comparison of CMR findings (LGE, T1/T2 mapping, ECV) with age- and sex-matched controls.
  • Application of updated Lake Louise criteria for myocardial inflammation assessment.

Main Results:

  • Genetic myopathy patients showed higher LGE, native T1, ECV, and T2 mapping values than controls, indicating chronic inflammation.
  • Inflammatory myopathy patients exhibited significantly elevated CMR tissue characterization indices, suggesting acute myocardial inflammation.
  • CMR effectively differentiated between genetic and inflammatory myopathies with high sensitivity and specificity (AUC=0.9557).

Conclusions:

  • Symptomatic inflammatory myopathy patients with normal echocardiography frequently present with acute myocardial inflammation.
  • Genetic myopathies are characterized by chronic, low-grade myocardial inflammation rather than acute inflammatory processes.
  • CMR is a valuable tool for detecting and characterizing cardiac involvement in various myopathies.
Abstract

Keywords:
ECVLGET1 mappingT2 mappingsubclinical

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