Giant Cell Myocarditis Depicted by Cardiac Magnetic Resonance Imaging

Shonk, Jason R.; Vogel‐Claussen, Jens; Halushka, Marc K.; Lima, João A.C.; Bluemke, David A.

doi:10.1097/01.rct.0000179243.54977.3f

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…9 However, EMB is indicated when the suspicion of giant cell myocarditis arises (reported sensitivity ranges between 82% and 85%), as this entity is frequently fatal from progressive cardiac failure or arrhythmias and can be ameliorated by immunosuppressive therapy and/or cardiac transplantation. 10,11 In a recent prospective study of biopsy-proven myocarditis, Caforio et al 12 identified giant cell myocarditis, in addition to biventricular failure, as one of the predictors of death/transplantation. Despite the aforementioned limitations, EMB is still considered the gold standard for the exclusion or diagnosis of suspected myocarditis.…”

Section: Endomyocardial Biopsymentioning

confidence: 98%

Diagnostic Approach and Role of MRI in the Assessment of Acute Myocarditis

Nelson

Afonso

2009

Cardiology in Review

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The diagnosis of acute myocarditis can be challenging, primarily because of the clinical diversity at presentation, the nonspecificity of traditional noninvasive tests, as well as the poor diagnostic yield and potential complications inherent with endomyocardial biopsy. Contrast-enhanced and nonenhanced cardiac magnetic resonance imaging (MRI) is emerging as an imaging modality of choice to diagnose and monitor the progression of myocarditis. MRI is nonionizing, non-nephrotoxic, and in comparison to coronary angiography, allows the clinician to rapidly eliminate irreversible ischemic injury (acute coronary syndrome) from the differential diagnosis. This timely review discusses the advantages and limitations of cardiac MRI over alternative diagnostic modalities and offers a practical approach to the contemporary diagnosis and assessment of acute myocarditis.

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Section: Endomyocardial Biopsymentioning

confidence: 98%

Diagnostic Approach and Role of MRI in the Assessment of Acute Myocarditis

Nelson

Afonso

2009

Cardiology in Review

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“…The presence of multinucleated giant cells on hematoxylin and eosin staining of endomyocardial biopsy samples is the pathologic hallmark of this entity as shown in Figures 1 and 2 from our own patient in this reported case. Although MRI is not sensitive enough to rule out GCM, it assists in the diagnosis by depicting areas of involvement and directing the necessary biopsy [10,11]. MRI also aids in the exclusion of other types of cardiomyopathy and provides quantitative measures of right and left ventricular function for assessing disease progression and prognosis [12].…”

Section: Discussionmentioning

confidence: 99%

Infiltrative Disease in Non-Ischemic Cardiomyopathy: Giant Cell Myocarditis Leading to Fulminant Myocarditis

Chan

2013

J Med Cases

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“…Current attempts to improve diagnostic accuracy include screening for viral RNA in EMBs 16, 17 , serum anti-heart autoantibodies 16 , and use of magnetic resonance imaging (MRI) 18, 19 . Transcriptomics has emerged as highly valuable tool for complex pathologic diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Transcriptomic Biomarkers for the Accurate Diagnosis of Myocarditis

et al. 2011

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Background Lymphocytic myocarditis is a clinically important condition that is difficult to diagnose and distinguish. We hypothesized that the transcriptome obtained from an endomyocardial biopsy (EMB) would yield clinically relevant and accurate molecular signatures. Methods and results Microarray analysis was performed on samples from patients with histologically proven lymphocytic myocarditis (n=16) and idiopathic dilated cardiomyopathy (IDCM, n=32) to develop accurate diagnostic transcriptome-based biomarkers (TBB) using multiple classification algorithms. We identified 9,878 genes differentially expressed in lymphocytic myocarditis vs. IDCM (FC>1.2, FDR<5%), from which a TBB containing 62 genes was identified, which distinguished myocarditis with 100% sensitivity (95% CI: 46-100%) and 100% specificity (95% CI: 66-100%) and which was generalizable to a broad range of secondary cardiomyopathies associated with inflammation (n=27), ischemic cardiomyopathy (n=8) and the normal heart (n=11). Multiple classification algorithms and quantitative realtime RT-PCR analysis further reduced this subset to a highly robust molecular signature of 13 genes, which still performed with 100% accuracy. Conclusions Together these findings demonstrate that transcriptomic biomarkers from a single EMB can improve the clinical detection of patients with inflammatory diseases of the heart. This approach advances the clinical management and treatment of cardiac disorders with highly variable outcome.

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Giant Cell Myocarditis Depicted by Cardiac Magnetic Resonance Imaging

Cited by 11 publications

References 5 publications

Diagnostic Approach and Role of MRI in the Assessment of Acute Myocarditis

Diagnostic Approach and Role of MRI in the Assessment of Acute Myocarditis

Infiltrative Disease in Non-Ischemic Cardiomyopathy: Giant Cell Myocarditis Leading to Fulminant Myocarditis

Transcriptomic Biomarkers for the Accurate Diagnosis of Myocarditis

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