Cardiac magnetic resonance in histologically proven eosinophilic myocarditis.
Cardiac magnetic resonance in histologically proven eosinophilic myocarditis.
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DOI：
10.1186/s12968-023-00979-0
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发表时间：
2023-12-18
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嗜酸性心肌炎(EM)是一种危及生命的急性心脏病。心脏磁共振(CMR)在评估心肌疾病方面表现出色，但对EM的CMR研究有限。我们的目标是描述组织学证实的EM的CMR表现。从2000年到2020年在一个学术中心看到的组织学证实的EM患者被识别出来。在确诊的28例患者中，15例接受了CMR诊断，构成了我们的研究队列。患者年龄为51 ± 17岁，临床表现为发热(53%)、呼吸困难(47%)、胸痛(53%)、心脏传导阻滞(20%)和血嗜酸性粒细胞增多(60%)。在CMR上，15例患者均有心肌水肿，其中10例(67%)同时伴有异常高的左心室(LV)质量。11例(73%)患者的左心室射血分数( )为50%，2例(13%)的左心室射血分数( )为30%，但仅6例(40%)左心室扩大。8例(53%)有心包积液。除1例(93%)外，其余患者均有LV晚期Gd强化(LGE)。LGE多位于心内膜下，但可累及任何心肌层。经组织病理学证实为坏死性EM的患者(n = 6)的LGE质量(32.1 ± 16.6%vs 14.5 ± 7.7%，p = 0.050)和LGE伴LGE的LV节段数(15 ± 2 vs 9 ± 3/17，p = 0.003)均高于无心肌细胞坏死者(n = 9)。2例左室血栓形成伴广泛心内膜下LGE。在EM中，CMR显示心肌水肿和LGE，通常位于心内膜下，但可累及任何心肌层。左心室常无扩张，伴有中度至重度的收缩功能障碍。心包积液很常见。坏死性EM在CMR上表现为广泛的心肌LGE。
Eosinophilic myocarditis (EM) is a life-threatening acute heart disease. Cardiac magnetic resonance (CMR) excels in the assessment of myocardial diseases but CMR studies of EM are limited. We aimed to describe CMR findings in histologically proven EM. Patients with histologically proven EM seen at an academic center from 2000 through 2020 were identified. Of the 28 patients ascertained, 15 had undergone CMR for diagnosis and constitute our study cohort. The patients, aged 51 ± 17 years, presented with fever (53%), dyspnea (47%), chest pain (53%), heart block (20%), and blood eosinophilia (60%). On CMR, all 15 patients had myocardial edema with 10 of them (67%) having abnormally high left ventricular (LV) mass as well. LV ejection fraction measured < 50% in 11 patients (73%) and < 30% in 2 (13%), but only 6 (40%) had dilated LV size. Eight patients (53%) had pericardial effusion. LV late gadolinium enhancement (LGE) was found in all but one patient (13/14; 93%). LGE was always multifocal and subendocardial but could involve any myocardial layer. Patients with necrotizing EM by histopathology (n = 6) had higher LGE mass (32.1 ± 16.6% vs 14.5 ± 7.7%, p = 0.050) and more LV segments with LGE (15 ± 2 vs 9 ± 3 out of 17, p = 0.003) than patients (n = 9) without myocyte necrosis. Two patients had LV thrombosis accompanying widespread subendocardial LGE. In EM, CMR shows myocardial edema and LGE that is typically subendocardial but can involve any myocardial layer. The left ventricle is often non-dilated with moderate-to-severe systolic dysfunction. Pericardial effusion is common. Necrotizing EM presents with extensive myocardial LGE on CMR.
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影响因子：
1
作者：
Kindermann, Michael;Sood, Nitin;Klingel, Karin
通讯作者：
Klingel, Karin
DOI：
10.1093/ehjci/jeac265
发表时间：
2023-03-21
期刊：
European heart journal. Cardiovascular Imaging
影响因子：
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作者：
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影响因子：
6.4
作者：
Deb, Kurt;Djavidani, Behrus;Luchner, Andreas
通讯作者：
Luchner, Andreas
影响因子：
37.8
作者：
Cerqueira, MD;Weissman, NJ;Verani, MS
通讯作者：
Verani, MS
DOI：
10.1056/nejmra0800028
发表时间：
2009-04-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cooper LT Jr
通讯作者：
Cooper LT Jr