The aim of this study was to investigate cardiac involvement in patients with idiopathic inflammatory myopathies excluding inclusion body myositis with cardiac magnetic resonance tomography (CMR). A case series of 53 patients with polymyositis, dermatomyositis, or non-specific myositis underwent CMR including functional imaging, T1-weighted, and late gadolinium enhancement (LGE) imaging. T1-weighted and LGE images were analyzed for myocardial enhancement. Reduced left ventricular function (LVF) was found in 9 (7%) patients. Patients with reduced LVF more often presented with early and late myocardial enhancement (p = 0.014 and p = 0.001). In 33 (62.3%) patients, LGE was observed by CMR. These patients had significantly lower left ventricular ejection fractions (p < 0.001) compared to patients without LGE. LGE was mainly present in the lateral (p < 0.01) and inferior (p < 0.02) segments. No correlations of LGE presence or reduced LVF to cardiovascular risk factors were found. Myocardial inflammation is very frequent in polymyositis, dermatomyositis, and non-specific myositis. In our patient, cohort CMR demonstrated signs of myocardial inflammation in 62.3%. CMR seems to offer a measurable and quantifiable diagnostic tool for cardiac involvement of idiopathic inflammatory myopathies and can thus be used to monitor disease progress and therapeutic success in these patients.
The factors like tobacco and caffeine consumption as well as vegetarian diet exerted no measurable effect on the prevalence of gallstones. A protective effect was found for alcohol consumption.
The objective of this study was to compare quantitative analysis of cardiac magnetic resonance (CMR) perfusion at 1.5 and 3 T against fractional flow reserve (FFR) as measured invasively. FFR is considered by many investigators to be a reliable standard to determine hemodynamically significant coronary artery stenoses. Quantitative 1.5 and 3 T CMR is capable to noninvasively determine myocardial perfusion reserve, but have not been compared against each other and validated against FFR as standard reference. Patients with suspected or known coronary artery disease (CAD) underwent CMR at at both field strengths, 1.5 and 3 T, and FFR. 34 patients were included into the study. Quantitative myocardial perfusion reserve was calculated in 544 myocardial segments at 1.5 and 3 T, respectively. FFR was measured in 109 coronary arteries. FFR ≤ 0.8 was regarded relevant. Reduced FFR (≤0.8) was found in 38 coronary arteries (19 LAD, 8 LCX and 11 RCA). Receiver operator curve analysis yielded higher area under the curve for 3 T CMR in comparison to 1.5 T CMR (0.963 vs. 0.645, p < 0.001) resulting in higher sensitivity (90.5 vs. 61.9 %) and specificity (100 vs. 76.9 %). Quantitative analysis of CMR myocardial perfusion reserve at 1.5 and 3 T is capable to detect hemodynamic significance of coronary artery stenoses. Diagnostic accuracy at 3 T is to be superior to 1.5 T.
Adenosine perfusion CMR provides excellent risk stratification and intermediate-term prognostic value in patients with stable coronary artery disease. The presence of a myocardial perfusion deficit is an incremental prognostic risk factor over other risk factors.
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