Management of Myocarditis in Myositis: Diagnosis and Treatment
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INFLAMMATORY MUSCLE DISEASE (L DIEDERICHSEN AND H CHINOY, SECTION EDITORS)
Management of Myocarditis in Myositis: Diagnosis and Treatment Katrine Aagaard Myhr 1 & Redi Pecini 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To provide a summary of the current knowledge on myocarditis in idiopathic inflammatory myopathies (IIMs). Recent Findings There is increasing epidemiological knowledge about heart involvement generally and myocarditis specifically in IIMs. Cardiac magnetic resonance (CMR) plays an important role in this regard. Summary Myocarditis occupies an important place in the spectrum of pathologies that involve the myocardium in patients with IIMs. Nevertheless, its full impact still remains to be elucidated. A larger cooperation between rheumatologists and cardiologists in the clinical, as well as in the research field, is necessary to expand our knowledge in the area. Keywords Idiopathic inflammatory myopathies . Myocarditis . Echocardiography . Cardiac magnetic resonance
Introduction As the myocardium shares many common features with the skeletal muscle, it can be affected by the same inflammatory processes, which take place during the different forms of idiopathic inflammatory myopathies (IIMs). Although evidence has been accumulating in support of a link between IIMs and cardiac involvement, the real extent of this link and the mechanisms behind it are less well understood [1, 2]. Different explanations are possible. The IIMs are a heterogenous group of diseases. On the other hand, the definition of “cardiac involvement” depends on the criteria used in the literature. Furthermore, the diagnosis of myocarditis in itself can be made based on different criteria, which results in different numbers of prevalence of myocarditis in the literature [3].
This article is part of the Topical Collection on Inflammatory Muscle Disease * Redi Pecini [email protected] Katrine Aagaard Myhr [email protected] 1
Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
2
Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
The extramuscular manifestations in IIMs, including heart involvement, has long caught the interest of rheumatologists resulting in a large European collaboration [4•]. However, there is still a lack of awareness in the heart departments and in the cardiology literature about the heart involvement generally and myocarditis specifically due to IIMs [5, 6]. This is probably due to the insensitivity of the current diagnostic methods to classify this particular type of myocarditis correctly. In this review, we assess the present knowledge on myocarditis in IIMs from the perspective of the cardiologist. In this regard, an overlap between the different concepts used to describe myocarditis due to IIMs and those used to describe other types of myocarditis will be unavoidable.
Definition Myocarditis is defined as an inflammatory process of
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