Cardiac Magnetic Resonance Monitors Reversible and Irreversible Myocardial Injury in Myocarditis

Zagrosek, Anja; Abdel-Aty, Hassan; Boyé, Philipp; Waßmuth, Ralf; Messroghli, Daniel; Utz, Wolfgang; Rudolph, André; Bohl, Steffen; Dietz, Rainer; Schulz‐Menger, Jeanette

doi:10.1016/j.jcmg.2008.09.014

Cited by 144 publications

(130 citation statements)

References 33 publications

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“…82 Key advantages include accuracy and reproducibility of LV and RV volumes and EF, and the ability to visualize preclinical myocardial changes prior to the onset of LV dysfunction, increased T2 weighted images associated with tissue edema resulting from acute myocardial inflammation and injury as seen in myocarditis. 83 A characteristic pattern of mid myocardial hyperenhancement has been reported in breast cancer patients receiving trastuzumab who experienced LV dysfunction. 84 T1 weighted hyperenhancement within 3 days of the first anthracycline administration was associated with decreased LVEF on day 28 after starting chemotherapy.…”

Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 95%

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

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The field of cardio-oncology is challenged to address an ever greater spectrum of cardiotoxicity associated with combination chemotherapy, greater dose intensity, extremes of age, and enhanced patient survival which exposes more protracted risk of developing congestive heart failure (CHF). Recent reports of chemotherapy-induced hypertension as a common adverse effect of angiogenesis inhibitors and immunosuppressants clarify the need for routine blood pressure (BP) monitoring and guideline-based management of hypertension as an integral strategy to preserve LV function. Serial monitoring of radionuclide left ventricular ejection fraction (LVEF) in adults and echocardiography in children continues to provide outcome based, cost-effective prevention of CHF in high risk patients receiving chemotherapy. To optimize treatment and monitoring strategies to eliminate late-onset LV dysfunction and CHF, traditional and novel candidate methods for assessment of chemotherapy-induced LV dysfunction are reviewed. These include serial assessment of LV volume indices by gated SPECT ERNA and gated SPECT MPI, 3D echocardiography and contrast 2D echocardiography; longitudinal strain imaging, diastolic functional parameters, 123 I-MIBG, 111 In-Antimyosin antibody imaging, and 99m Tc-Annexin V apoptosis imaging, biomarkers including troponins and BNP; genetic markers, and both functional and tissue characterization techniques with T1 weighted and T2 weighted images with cardiac magnetic resonance imaging (CMR). In our quest to optimize strategies for long-term cancer survival and prevention of CHF for patients receiving chemotherapy, rigorous modality and guideline-specific clinical outcome trials are required. A new multi-modality monitoring approach is proposed, which integrates evidencebased strengths of CMR, echocardiography, ERNA, biomarkers, and BP management for surveillance and validation of cardiotoxicity and prevention of clinical heart failure in patients receiving a broad spectrum of cancer therapies.

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Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 95%

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

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“…Среди технологий лучевой диагностики миокар-дита МРТ сердца обладает наибольшей точностью [5][6][7][8][9]. Тем не менее, не всегда удается обнаружить два и более признака повреждения сердечной мышцы.…”

Section: Discussionunclassified

“…В последние годы широкую распространенность для визуализации воспалительных изменений в миокарде получила магнитно-резонансная томография (МРТ) сердца с контрастным усилением [5][6][7]. В 2009г были предложены и в последующем утверждены три диагно-стических МРТ критерия миокардита (Lake Louise Criteria): гиперемия, отек и позднее контрастное усиле-ние (LGE) как маркер необратимого повреждения (некроз/фиброз) миокарда [9].…”

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Magnetic Resonance Imaging of the Heart in Diagnostics of Various Types of Myocarditis

Игнатьева¹,

Ryzhkova²,

Митрофанова³

et al. 2017

Russ J Cardiol

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Цель. Изучение лучевой семиотики различных клинико-морфологических форм миокардита с помощью магнитно-резонансной томографии (МРТ). Материал и методы. В исследование включены 70 больных с подозрением на миокардит по клинико-лабораторным данным (28 женщин и 42 мужчины; средний возраст -37,0±13,1 лет). Всем пациентам была выполнена эндомио-кардиальная биопсия (ЭМБ) и МРТ с внутривенным контрастированием. Чув-ствительность методики МРТ оценивалась относительно данных ЭМБ. Крите-рием исключения являлась сопутствующая ишемическая болезнь серд ца. Результаты. Из 70 пациентов с гистологически верифицированным миокар-дитом, только у 47 больных был установлен диагноз по результатам МРТ серд ца, чувствительность метода составила 67%. При остром активном и остром пограничном миокардитах отмечена высокая чувствительность МРТ -86%; при хроническом активном миокардите -74%, у пациентов с хро-ническим пограничным миокардитом -55%. Три МРТ-критерия миокардита с наибольшей частотой наблюдались при остром активном миокардите. Острый пограничный миокардит в большинстве случаев характеризовался сочетанием 2-х признаков: отека и позднего контрастного усиления. Значи-мым отличием активного миокардита от других клинико-морфологических форм является преобладание трансмурального паттерна позднего контрасти-рования. Также установлена сопряженность между активностью воспаления по данным ЭМБ и выраженностью отека миокарда (64,3% против 40,5%, р=0,005). Отличительным признаком хронического миокардита является слив-ной характер участков позднего контрастирования, которые превосходят по площади зоны отека сердечной мышцы. Заключение. Магнитно-резонансная томография сердца обладает наиболее высокой чувствительностью в выявлении острого миокардита, в случаях хро-нического миокардита чувствительность метода зависит от активности воспа-ления. Совпадение по площади участков позднего контрастирования и отека миокарда позволяют дифференцировать острый и хронический воспалитель-ный процесс в миокарде. Диагностика хронического пограничного миокар-дита невозможна без выполнения эндомиокардиальной биопсии. MAGNEtIC RESONANCE IMAGING OF tHE HEARt IN DIAGNOStICS OF VARIOUS tYPES OF MYOCARDItISIgnatieva E. S., Ryzhkova D. V., Mitrofanova L. B., Moiseeva O. M. Aim.To study the radiation semiotics of various clinical and morphological types of myocarditis with magnetic resonance imaging (MRI). Material and methods. Totally, 70 patients included, with suspected by clinical and lab data myocarditis (28 females, 42 males; mean age 37,0±13,1 y.o). All patients underwent endomyocardial biopsy (EMB) and MRI with intravenous contrasting. Sensitivity of MRI method was evaluated with relation to EMB. Exclusion criteria had been the comorbid ischemic heart disease. Results. Among 70 patients with histologically verified myocarditis, only 47 had this diagnosis by MRI data, sensitivity was set as 67%. In acute active and acute borderline myocardities there is high sensitivity of MRI -86%; in chronic active myocarditis -74%, in patients with chronic borderline myocardit...

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“…Nevertheless, due to its good temporal and spatial resolution, CMR is considered the gold standard for the assessment of LV function; (47) is exquisitely sensitive for the detection of unrecognised subendocardial myocardial infarctions by SPECT perfusion imaging; (48) and through T2-weighted imaging, has the unique potential to detect myocardial oedema. (49) Perhaps for these reasons, the American College of Cardiology & American Heart…”

Section: Rotationalmentioning

confidence: 99%

Non-invasive cardiac imaging for evaluation of cardiotoxicity in cancer patients - early detection and follow-up

Vorobiof

Silverstein

2017

SAHJ

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and early identification of cardiac toxicity during and after treatment.Non-invasive cardiac imaging techniques have been widely used for identification of patients with pre-clinical and clinical cardiotoxicity as well as for follow-up. Until recently, these modalities were predominantly limited to echocardiography and radioisotope-based nuclear imaging, but cardiac magnetic resonance has emerged and appears to may have unique advantages over traditional techniques.Coronary computed tomography, likely due to its relative lack of physiologic information, need for ionising radiation and nephrotoxic contrast, has thus far not been widely investigated in this patient population. NUCLEAR CARDIOLOGYIdentifying patients at risk for the development of cardiotoxicity is

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Cardiac Magnetic Resonance Monitors Reversible and Irreversible Myocardial Injury in Myocarditis

Abstract: A comprehensive CMR approach is a useful tool to monitor the reversible and irreversible myocardial tissue injuries over the course of myocarditis and to differentiate acute from healed myocarditis in patients with still-preserved ejection fraction.

Cited by 144 publications

References 33 publications

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Magnetic Resonance Imaging of the Heart in Diagnostics of Various Types of Myocarditis

Non-invasive cardiac imaging for evaluation of cardiotoxicity in cancer patients - early detection and follow-up

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