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Early diagnosis of cardiac involvement in idiopathic inflammatory myopathy by cardiac magnetic resonance tomography

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Abstract

The aim of this study was to investigate cardiac involvement in patients with idiopathic inflammatory myopathies excluding inclusion body myositis with cardiac magnetic resonance tomography (CMR). A case series of 53 patients with polymyositis, dermatomyositis, or non-specific myositis underwent CMR including functional imaging, T1-weighted, and late gadolinium enhancement (LGE) imaging. T1-weighted and LGE images were analyzed for myocardial enhancement. Reduced left ventricular function (LVF) was found in 9 (7 %) patients. Patients with reduced LVF more often presented with early and late myocardial enhancement (p = 0.014 and p = 0.001). In 33 (62.3 %) patients, LGE was observed by CMR. These patients had significantly lower left ventricular ejection fractions (p < 0.001) compared to patients without LGE. LGE was mainly present in the lateral (p < 0.01) and inferior (p < 0.02) segments. No correlations of LGE presence or reduced LVF to cardiovascular risk factors were found. Myocardial inflammation is very frequent in polymyositis, dermatomyositis, and non-specific myositis. In our patient, cohort CMR demonstrated signs of myocardial inflammation in 62.3 %. CMR seems to offer a measurable and quantifiable diagnostic tool for cardiac involvement of idiopathic inflammatory myopathies and can thus be used to monitor disease progress and therapeutic success in these patients.

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Acknowledgments

This work was partially supported by a grant from the German Society of Muscle Disease (Deutsche Gesellschaft für Muskelkranke e.V (DGM). We thank Helga Mogel for excellent technical support concerning the muscle biopsies.

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standard

The study was approved by the local ethic committee and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Neurology, University of Ulm, Ulm, Germany

    Angela Rosenbohm, Jan Kassubek & Albert C. Ludolph

  2. Department of Internal Medicine II, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    Dominik Buckert, Nora Gerischer, Thomas Walcher, Wolfgang Rottbauer & Peter Bernhardt

Authors
  1. Angela Rosenbohm
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  2. Dominik Buckert
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  3. Nora Gerischer
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  4. Thomas Walcher
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  5. Jan Kassubek
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  6. Wolfgang Rottbauer
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  7. Albert C. Ludolph
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  8. Peter Bernhardt
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Corresponding author

Correspondence to Peter Bernhardt.

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Rosenbohm, A., Buckert, D., Gerischer, N. et al. Early diagnosis of cardiac involvement in idiopathic inflammatory myopathy by cardiac magnetic resonance tomography. J Neurol 262, 949–956 (2015). https://doi.org/10.1007/s00415-014-7623-1

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  • DOI: https://doi.org/10.1007/s00415-014-7623-1

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