Sporadic inclusion body myositis: no specific cardiac involvement in cardiac magnetic resonance tomography

Abstract

Objective To investigate cardiac involvement in patients with sporadic inclusion body myositis (IBM) by cardiac magnetic resonance tomography (CMR). Methods A case series of 20 patients with IBM underwent basic cardiac assessment and CMR including functional imaging, native and contrast-enhanced T1-weighted, and late gadolinium enhancement (LGE) imaging. Results All IBM patients reported no cardiac symptoms. Echocardiography was normal in 16/17 IBM patients. In CMR, IBM patients had normal ejection fractions (mean LVEF 63 ± 7%) and ventricular mass. They had reduced left (mean 55 versus 88 ml) and right ventricular stroke volumes (mean 54 versus 86 ml) and increased early myocardial enhancement (pathological T1 Ratio in 44% versus 5%), as compared to age-and gender-matched controls. Since arterial hypertension was more often observed in IBM patients, hypertensive heart disease can also be causative for these changes. Late gadolinium enhancement did not differ statistically from healthy controls. There was no apparent association between elevated biomarkers, echocardiography and CMR. Conclusion CMR revealed subtle changes in cardiac geometry and tissue characterization in IBM patients when compared to a gender-and age-matched control group. Findings in CMR indicated a higher extent of diffuse myocardial fibrosis as well as smaller left ventricular stroke volumes. These alterations may be due to a higher prevalence of arterial hypertension in the IBM cohort.

Multiparametric Cardiac Magnetic Resonance Imaging of Cardiac Involvement Associated With Sporadic Inclusion Body Myositis

“…In a recent study by Key Words: biopsy ◼ gadolinium ◼ myocardium ◼ myositis, inclusion body ◼ troponin T Rosenbohm et al, 35% of patients with IBM reportedly had LGE on CMR. 2 Although the authors concluded that it was a nonspecific finding in the case series, we speculate that it is subclinical cardiac involvement associated with IBM. Imaging shows LGE is most common in the inferior and inferolateral segments, which is similar to the findings of cardiac involvement in dermatomyositis and polymyositis.…”

In-patient comorbidities in inclusion body myositis: a United States national in-patient sample-based study

“…In this study, the rate of atrial fibrillation, sub-endocardial infarction, and strokes were higher in IBM patients. While higher frequency of hypertension, hyperlipidaemia, myocardial infarction, and congestive heart failure in IBM patients was reported in a single study, focused studies did not find any definitive cardiac involvement in IBM patients (33,34). On the other hand, higher rates of atrial fibrillation in patients with IIM compared to patients with other autoimmune diseases has been reported (35,36).…”

Cardiovascular manifestations in idiopathic inflammatory myopathies

“…However, these changes were attributed to hypertensive heart disease in these patients. Of note, there was no statistical difference in the LGE between patients and controls [ 104 ].…”