Abstract
Cardiac involvement in patients with idiopathic inflammatory myopathies (autoimmune myositis) is important to detect because it confers an increased risk of mortality. However, detection of myocardial involvement is hampered by a lack of sensitivity of traditional non-invasive methods, and the finding of elevated cardiac troponin T levels that may be due to regenerating skeletal muscle, rather than myocardial damage. Here, we describe three cases of inflammatory myositis with elevated troponin T levels, and non-specific echocardiographic and ECG findings. Cardiac MR imaging was useful in the evaluation for the presence of myocarditis or alternative cardiac pathology.
References
Danko K, Ponyi A, Constantin T, Borgulya G, Szegedi G (2004) Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine (Baltimore) 83:35–42
Lundberg IE (2006) The heart in dermatomyositis and polymositis. Rheumatology (Oxford) 45:iv18–iv21
Taylor AJ, Wortham DC, Burge JR, Rogan KM (1993) The heart in polymyositis: a prospective evaluation of 26 patients. Clin Cardiol 16:802–808
Stern R, Godbold JH, Chess Q, Kagen LJ (1984) ECG abnormalities in polymyositis. Arch Intern Med 144:2185–2189
Gottdiener JS, Sherber HS, Hawley RJ, Engel WK (1978) Cardiac manifestations in polymyositis. Am J Cardiol 41:1141–1149
Erlacher P, Lercher A, Falkensammer J, Nassonov E, Samsonov MI, Shtutman V, Puschendorf B, Mair J (2001) Cardiac troponin and β-type myosin heavy chain concentrations in patients with polymyositis or dermatomyositis. Clinica Chimica Acta 306:27–33
Ricchiuti V, Apple FS (1999) RNA expression of cardiac troponin T isoforms in diseased human skeletal muscle. Clin Chem 45:2129–2135
Bodor GS, Survant L, Voss EM, Smith S, Porterfield D, Apple FS (1997) Cardiac troponin T composition in normal and regenerating human skeletal muscle. Clin Chem 43:476–484
Haupt HM, Hutchins GM (1982) The heart and cardiac conduction system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients. Am J Cardiol 50:998–1006
Denbow CE, Lie JT, Tancredi RG, Bunch TW (1979) Cardiac involvement in polymyositis: a clinicopathologic study of 20 autopsied patients. Arthritis Rheum 22:1088–1092
Ohata S, Shimada T, Shimizu H, Murakami Y (2002) Myocarditis associated with polymyositis diagnosed by gadolinium-DTPA enhanced magnetic resonance imaging. J Rheumatol 29:861–862
Abu-Soud HM, Hazen SL (2000) Nitric oxide is a physiological substrate for mammalian peroxidases. J Biol Chem 275:37524–37532
McCrohon JA, Moon JCC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJS, Pennell DJ (2003) Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 108:54–59
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Toong, C., Puranik, R. & Adelstein, S. Use of cardiac MR imaging to evaluate the presence of myocarditis in autoimmune myositis: three cases. Rheumatol Int 32, 779–782 (2012). https://doi.org/10.1007/s00296-009-1324-6
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DOI: https://doi.org/10.1007/s00296-009-1324-6