PMID- 25643434
OWN - NLM
STAT- MEDLINE
DCOM- 20150219
LR  - 20191113
IS  - 0001-5385 (Print)
IS  - 0001-5385 (Linking)
VI  - 69
IP  - 6
DP  - 2014 Dec
TI  - Late gadolinium enhancement on CMR and sustained ventricular tachycardia predict 
      severe cardiac inflammation.
PG  - 637-47
AB  - OBJECTIVE: Early diagnosis of severe inflammatory forms of non-ischaemic 
      cardiomyopathy (NICM), e.g. cardiac sarcoidosis (CS) or giant cell myocarditis 
      (GCM), may enable unique treatment. However, there is limited information on how 
      to identify CS or GCM in unselected patients with suspected NICM. We studied the 
      clinical and imaging predictors of severe cardiac inflammation at the era of late 
      gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR). METHODS AND 
      RESULTS: In this observational cohort study, we enrolled 86 consecutive patients 
      referred for LGE-CMR due to suspected NICM. Patients were extensively examined 
      for underlying aetiology and followed up for at least two years to assure the 
      final diagnosis. Ischaemic cardiomyopathy was excluded. During follow-up, 11(13%) 
      patients were diagnosed with CS (n = 8) or GCM (n = 3). At baseline, sustained 
      ventriculartachycardia (OR = 20.8, P = 0.001) and the volume of left ventricular 
      LGE (OR = 1.06 for each 1% increase in LGE, P = 0.001) were significant adjusted 
      predictors of CS or GCM. Palpitation, a disease course less than 3 months, septal 
      abnormality in echocardiography, reduced stroke volume and atrioventricular block 
      were other unadjusted predictors of CS or GCM. Multifocal LGE, affecting several 
      myocardial layers and not confined to coronary artery perfusion territories, was 
      useful in identifying CS or GCM, with 52-fold unadjusted OR (P < 0.001), 
      sensitivity of 91% and specificity of 84%. In addition, positron emission 
      tomography detected mediastinal lymph node biopsy targets in CS. CONCLUSIONS: In 
      consecutive patients suspected for NICM, LGE volume and sustained ventricular 
      tachycardia predict independently CS or GCM. Multifocal LGE is useful in 
      identifying severe cardiac inflammation.
FAU - Poyhonen, Pauli
AU  - Poyhonen P
FAU - Holmstrom, Miia
AU  - Holmstrom M
FAU - Kivisto, Sari
AU  - Kivisto S
FAU - Hanninen, Helena
AU  - Hanninen H
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Acta Cardiol
JT  - Acta cardiologica
JID - 0370570
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 0 (Radiopharmaceuticals)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
RN  - 6HG8UB2MUY (Meglumine)
RN  - L0ND3981AG (gadoterate meglumine)
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - Cardiomyopathies/*diagnosis/pathology
MH  - *Contrast Media
MH  - Echocardiography
MH  - Female
MH  - Fluorodeoxyglucose F18
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - *Meglumine
MH  - Middle Aged
MH  - *Organometallic Compounds
MH  - Predictive Value of Tests
MH  - Radiopharmaceuticals
MH  - Retrospective Studies
MH  - Tachycardia, Ventricular/*diagnosis/pathology
MH  - Tomography, Emission-Computed, Single-Photon
EDAT- 2015/02/04 06:00
MHDA- 2015/02/20 06:00
CRDT- 2015/02/04 06:00
PHST- 2015/02/04 06:00 [entrez]
PHST- 2015/02/04 06:00 [pubmed]
PHST- 2015/02/20 06:00 [medline]
AID - 10.1080/ac.69.6.1000006 [doi]
PST - ppublish
SO  - Acta Cardiol. 2014 Dec;69(6):637-47. doi: 10.1080/ac.69.6.1000006.