Cardiac magnetic resonance in giant cell myocarditis: a matched comparison with cardiac sarcoidosis.
Cardiac magnetic resonance in giant cell myocarditis: a matched comparison with cardiac sarcoidosis.
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DOI：
10.1093/ehjci/jeac265
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发表时间：
2023-03-21
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影响因子：
--
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中科院分区：
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巨细胞心肌炎（GCM）是一种类似于心脏结节病（CS）的炎性心肌病。我们决定研究GCM在心脏磁共振（CMR）成像中的发现，并将GCM与CS进行比较。对18例GCM患者的CMR研究进行了分析，并与18例年龄、性别、左心室（LV）射血分数和心脏表现相匹配的CS对照进行了比较。分析员对临床数据设盲。入院时，GCM组症状持续时间（中位数）为0.2个月，CS组为2.4个月（P = 0.002），心肌肌钙蛋白T升高（>50 ng/L），16/17例GCM患者和2/16例CS患者血浆B型利钠肽中位数分别为4488 ng/L和1223 ng/L（P = 0.011）。在CMR成像中，GCM组的LV舒张期容积较小（177 ± 32 mL vs. 211 ± 58 mL，P = 0.014），两组之间无其他体积或壁厚测量值差异。每个GCM患者都有多灶性晚期钆增强（LGE），其分布在LV节段的纵向、周向和径向上与CS难以区分。GCM组LGE质量平均为LV质量的17.4 ± 6.3%，CS组为25.0 ± 13.4%（P = 0.037）。53%的GCM和50%的CS出现了跨越室间隔进入右室壁的插入点，即CS的“钩状征”。在GCM中，尽管心肌炎症在临床上更为急性和有害，但CMR结果与CS定性上无法区分。当匹配LV功能障碍和表现特征时，GCM中的LV大小和LGE质量较小。巨细胞心肌炎（GCM）和心脏结节病（CS）心脏磁共振心肌晚期钆增强（LGE）总结。GCM和CS具有不可区分的LGE分布，但对于匹配的LV功能障碍，GCM中的LGE量较低。
Giant cell myocarditis (GCM) is an inflammatory cardiomyopathy akin to cardiac sarcoidosis (CS). We decided to study the findings of GCM on cardiac magnetic resonance (CMR) imaging and to compare GCM with CS. CMR studies of 18 GCM patients were analyzed and compared with 18 CS controls matched for age, sex, left ventricular (LV) ejection fraction and presenting cardiac manifestations. The analysts were blinded to clinical data. On admission, the duration of symptoms (median) was 0.2 months in GCM vs. 2.4 months in CS (P = 0.002), cardiac troponin T was elevated (>50 ng/L) in 16/17 patients with GCM and in 2/16 with CS (P < 0.001), their respective median plasma B-type natriuretic propeptides measuring 4488 ng/L and 1223 ng/L (P = 0.011). On CMR imaging, LV diastolic volume was smaller in GCM (177 ± 32 mL vs. 211 ± 58 mL, P = 0.014) without other volumetric or wall thickness measurements differing between the groups. Every GCM patient had multifocal late gadolinium enhancement (LGE) in a distribution indistinguishable from CS both longitudinally, circumferentially, and radially across the LV segments. LGE mass averaged 17.4 ± 6.3% of LV mass in GCM vs 25.0 ± 13.4% in CS (P = 0.037). Involvement of insertion points extending across the septum into the right ventricular wall, the “hook sign” of CS, was present in 53% of GCM and 50% of CS. In GCM, CMR findings are qualitatively indistinguishable from CS despite myocardial inflammation being clinically more acute and injurious. When matched for LV dysfunction and presenting features, LV size and LGE mass are smaller in GCM. Summary of myocardial late gadolinium enhancement (LGE) by cardiac magnetic resonance in giant cell myocarditis (GCM) and cardiac sarcoidosis (CS). GCM and CS have indistinguishable LGE distribution but, for matched LV dysfunction, the quantity of LGE is lower in GCM.
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影响因子：
2.1
作者：
通讯作者：
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影响因子：
37.8
作者：
Cerqueira, MD;Weissman, NJ;Verani, MS
通讯作者：
Verani, MS
影响因子：
37.8
作者：
Sievers, Burkhard;Elliott, Michael D.;Kim, Raymond J.
通讯作者：
Kim, Raymond J.
影响因子：
1.2
作者：
Hayase, Misa;Nagashima, Koichi;Hirayama, Atsushi
通讯作者：
Hirayama, Atsushi
DOI：
10.1016/s0735-1097(02)02715-8
发表时间：
2003-01-15
影响因子：
24
作者：
Okura, Y;Dec, GW;Cooper, LT
通讯作者：
Cooper, LT