Cardiac involvement in idiopathic inflammatory myopathies detected by cardiac magnetic resonance imaging

Thomas Khoo, Michael B. Stokes, Karen Teo, Susanna Proudman, Sajini Basnayake, Prashanthan Sanders, Vidya Limaye

Research output: Contribution to journalArticle

Abstract

Cardiac involvement in idiopathic inflammatory myopathies (IIM) adversely affects prognosis but is commonly sub-clinical. Cardiac magnetic resonance imaging (CMR) is an effective imaging modality for detecting myocardial inflammation and fibrosis but its use as a screening tool for cardiac disease in IIM has not been fully explored. Nineteen patients with IIM without cardiac symptoms underwent CMR using a specific cardiomyopathy protocol including specific sequences detecting focal and diffuse myocardial fibrosis. 9/19 patients demonstrated late gadolinium enhancement (LGE (3/9 right ventricular insertion, 1/9 sub-endocardial, 7/9 mid-wall/sub-epicardial)). T1 mapping was performed in 15 patients. In total, 7/15 had elevated native T1 values, of which four had detected LGE. Myocardial fibrosis was frequently detected in IIM patients without cardiac history. Detection of LGE and elevated T1 values may have negative prognostic implications. Longitudinal studies determining whether early or augmented treatment has a role in patients with sub-clinical cardiac involvement are needed.Key Points• Cardiac involvement in myositis adversely affects prognosis.• Cardiac magnetic resonance imaging is an effective tool for detecting cardiac involvement.• T1 mapping is a technique which detects diffuse myocardial inflammation and fibrosis.• In our study, focal and diffuse myocardial fibrosis was frequently found in myositis patients without cardiac symptoms.

LanguageEnglish
Pages3471-3476
Number of pages6
JournalClinical Rheumatology
Volume38
Issue number12
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • Cardiac magnetic resonance imaging
  • Cardiomyopathy
  • Heart failure
  • Idiopathic inflammatory myopathy
  • Myocardial fibrosis
  • Myocarditis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Khoo, T., Stokes, M. B., Teo, K., Proudman, S., Basnayake, S., Sanders, P., & Limaye, V. (2019). Cardiac involvement in idiopathic inflammatory myopathies detected by cardiac magnetic resonance imaging. Clinical Rheumatology, 38(12), 3471-3476. https://doi.org/10.1007/s10067-019-04678-z