Myocarditis in connective tissue diseases: an often-overlooked clinical manifestation

Azzam, Muayad I.; Awad, Adnan M.; Abugharbyeh, Aya; Kahaleh, Bashar

doi:10.1007/s00296-023-05428-w

Cited by 1 publication

(1 citation statement)

References 103 publications

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“…Myocardial involvement has also been described in other inflammatory myopathies and autoimmune disorders, with a wide range of clinical manifestations from subclinical involvement to fulminant myocarditis (28)(29)(30). In a retrospective study, early myocardial involvement in DM and PM was also detected by CMR (16).…”

Section: Acute Phase Cmrmentioning

confidence: 95%

Subclinical myocardial involvement in a cohort of patients with antisynthetase syndrome

Gil-Vila,

Burcet-Rodriguez,

Trallero-Araguás

et al. 2024

Clinical and Experimental Rheumatology

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ObjectiveThere is an increasing interest in knowing whether patients with antisynthetase syndrome (ASSD) may have silent myocardial interstitial involvement. Mapping techniques in cardiac magnetic resonance (CMR) can detect subclinical myocardial involvement. The purpose of this study was to identify alterations in multiparametric CMR in ASSD patients without overt cardiac involvement. Methods Patients diagnosed with ASSD underwent a CMR along with the standard clinical workup, investigation of specific and associated myositis antibodies, and high-resolution chest CT. The CMR protocol includes routine morphologic,functional, and late gadolinium enhancement sequences in standard cardiac planes, as well as native T1 and T2 mapping sequences and extracellular volume (ECV) calculation. ResultsTwenty-five patients were included in this study (56% women; median age 56.3 years). Three patients were considered in the acute phase at the time of inclusion. Eight patients (32%) showed pathological findings in CMR (6 stable disease, 2 acute phase). Elevated T1, T2 and ECV mapping values were found in 20% (5/25), 17% (4/25) and 24% (6/25) of the group, respectively. Two patients in the acute phase had increased values of both T2 and ECV. ConclusionSubclinical myocardial involvement in ASSD is not rare (32%) although its clinical significance is uncertain. Myocardial oedema (T2) was the most frequent finding, followed by increased T1 and/or ECV values likely signalling interstitial fibrosis. Of note, patients in the acute phase showed elevated T2 values.

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