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Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
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Phenotyping of giant cell myocarditis versus cardiac sarcoidosis using cardiovascular magnetic resonance

Emanuele Bobbio1, Entela Bollano1, Anders Oldfors2

  • 1Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

International Journal of Cardiology
|June 26, 2023
PubMed

Insights

Giant cell myocarditis (GCM) and cardiac sarcoidosis (CS) present similarly on cardiovascular magnetic resonance (CMR) imaging, making differentiation difficult. However, GCM shows more severe clinical presentation and higher biomarker levels than CS.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Inflammatory Diseases

Background:

  • Giant cell myocarditis (GCM) and cardiac sarcoidosis (CS) are rare, severe myocardial inflammatory diseases.
  • Limited knowledge exists regarding the cardiovascular magnetic resonance (CMR) characteristics of GCM and its differentiation from CS.

Purpose of the Study:

  • To compare the clinical and CMR findings of GCM and CS.
  • To assess the utility of CMR in distinguishing between GCM and CS.

Main Methods:

  • A blinded analysis of clinical data and CMR imaging was performed on 40 patients with biopsy-proven GCM (n=14) and CS (n=26).
  • CMR parameters assessed included ventricular dimensions, function, late gadolinium enhancement (LGE), and T2 signal intensity.

Main Results:

  • Patients with GCM and CS had similar demographics and CMR findings, including ventricular alterations and LGE patterns (e.g., "hook sign").
  • GCM cases exhibited significantly higher troponin T and natriuretic peptide levels and a worse clinical outcome compared to CS.
  • Right ventricular involvement with increased T2 signal and/or LGE was most extensive in GCM.

Conclusions:

  • CMR imaging reveals highly similar patterns for GCM and CS, challenging differentiation based solely on imaging.
  • Clinical presentation and biomarker levels appear more severe in GCM, offering potential distinguishing features.
Abstract

Keywords:
Cardiac sarcoidosisCardiovascular magnetic resonanceGiant cell myocarditisInflammatory cardiomyopathyMyocarditis

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