2033 Frequent detection of myocardial inflammation in autoimmune diseases
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Meeting abstract
2033 Frequent detection of myocardial inflammation in autoimmune diseases Sophie Mavrogeni*1, Menelaos Manousakis2, Konstantinos Spargias1, Marouso Douskou3, Haralambos Moutsopoulos2, Loukas Kaklamanis1 and Dennis V Cokkinos1 Address: 1Onassis Cardiac Surgery Center, Athens, Greece, 2Dept Pathophysiology, Athens University, Athens, Greece and 3Bioiatriki MRI Unit, Athens, Greece * Corresponding author
from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A302
doi:10.1186/1532-429X-10-S1-A302
Abstracts of the 11th Annual SCMR Scientific Sessions - 2008
Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdfThis abstract is available from: http://jcmr-online.com/content/10/S1/A302 © 2008 Mavrogeni et al; licensee BioMed Central Ltd.
Introduction Autoimmune diseases that are associated with active myocarditis include systemic lupus erythematosus, rheumatoid arthritis, Takayasu's arteritis, systemic sclerosis and autoimmune thyroid disease. Patients may show myocarditis and/or pericarditis causing both short- and long-term morbidity and mortality.
Purpose To detect the presence of possible myocardial inflammation in patients with autoimmune diseases using CMR, immunohistological and PCR techniques.
Methods Seventeen patients, aged 20–55 yrs with various autoimmune diseases (2 with Takayasu's arteritis, 9 with systemic lupus erythematosus, 3 with rheumatoid arthritis, 2 with autoimmune thyroid disease and 1 with systemic sclerosis) presented with chest pain, shortness of breath or palpitations were included in the study. All patients were in immunosuppressive treatment. Two of them had slight increase of myocardial troponin I (2.5–3.5 ng/ml). After exclusion of coronary artery disease by coronary angiography, the presence of myocardial inflammation and the left ventricular systolic function were evaluated by Cardiovascular Magnetic Resonance (CMR). Myocardial inflammation was documented using T2-weighted (T2-w), T1weighted (T1-w) before and after contrast media injection
and late enhanced images. In 8/17 patients diagnosed by CMR as having myocardial inflammation, myocardial biopsy was also performed. Biopsy specimens were evaluated by both immunohistological and polymerase reaction techniques (PCR).
Results Myocardial inflammation was identified in 12/17 patients using CMR. In the T2-w images the signal ratio of myocardium to skeletal muscle (latissimus dorsi) was 1.66 ± 0.58 (normal values 1.28 ± 0.05), indicative of myocardial oedema. From the T1-w images the relative myocardial enhancement was 10.8 ± 12.4 (normal values 2.3 ± 0.69), indicative of myocardial inflammation. Epicardial late gadolinium enhanced areas were also identified in 12/17 (in 5 patients in the intraventricular septum (IVS), in 3 in the inferolateral wall (INFL)
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