Cardiac Magnetic Resonance Imaging in Inflammatory Diseases

Nilgün IŞIKSALAN ÖZBÜLBÜLa
aAnkara Bilkent City Hospital, Clinic of Radiology, Ankara, Türkiye

Işıksalan Özbülbül N. Cardiac magnetic resonance imaging in inflammatory diseases. In: Bayraktaroğlu S, ed. Advances in Cardiovascular System Imaging. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.40-6.

ABSTRACT
Myocarditis is an inflammation of the myocardium due to infectious or noninfectious causes. The diagnosis and treatment of acute myocarditis is important as it is the 2nd most common cause of acute chest pain in emergency departments. The most common cause is viral infections. It usually presents with acute chest pain, is usually self-limiting, but can cause acute heart failure, malignant arrhythmias, fulminant course and dilated cardiomyopathy. Laboratory and electrocardiogram (ECG) findings are nonspecific. Cardiac magnetic resonance imaging (MRI) is the gold standard for suspicion of acute myocarditis in the symptomatic patient. In this section, we planned to review viral myocarditis and Cardiac MRI findings including recent studies.

Keywords: Cardiac magnetic resonance; myocarditis; cardiac imaging techniques

Referanslar

  1. Lewis AJM, Burrage MK, Ferreira VM. Cardiovascular magnetic resonance imaging for inflammatory heart diseases. Cardiovascular Diagnosis and Therapy 2020; 10(3):598-609. [Crossref]
  2. Blauwet LA, Cooper LT. Myocarditis. Prog Cardiovasc Dis. 2010; 52(4): 274-88. [Crossref]
  3. Adeboye A, Alkhatib D, Butt A, Yedlapati N, Garg N. A review of the role of imaging modalities in the evaluation of viral myocarditis with a special focus on COVID-19-related myocarditis. Diagnostics (Basel) 2022;12(2):549. [Crossref]
  4. Cooper LT Jr. Myocarditis. N Engl J Med. 2009;360(15):1526-38. [Crossref]
  5. Chopra H, Arangalage D, Bouleti C, Zarka S, Fayard F, Chillon S, et al. Prognostic value of the infarct- and no n-infarct like patterns and cardiovascular magnetic resonance parameters on long-term outcome of patients after acute myocarditis. Int J Cardiol. 2016;212:63-9. [Crossref]
  6. Mewton N, Dernis A, Bresson D, Zouaghi O, Croisille P, Flocard E, et al. Myocardial biomarkers and delayed enhanced cardiac magnetic resonance relationship in clinically suspected myocarditis and insight on clinical outcome. J Cardiovasc Med. 2015;16:696-703. [Crossref]
  7. Sozzi FB, Gherbesi E, Faggiano A, Gnan E, Maruccio A, Schiavone M, et al. Viral Myocarditis: Classification, Diagnosis, and Clinical Implications. Front Cardiovasc Med. 2022;9:908663. [Crossref]
  8. Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, et al. Management of Acute Myocarditis and Chronic Inflammatory Cardiomyopathy: An Expert Consensus Document. Circ Heart Fail. 2020;13(11):e007405. [Crossref]
  9. Caobelli F, Cabrero JB, Galea N, Haaf P, Loewe C, Luetkens JA, Muscogiuri G, et al. Cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) imaging in the diagnosis and follow-up of patients with acute myocarditis and chronic inflammatory cardiomyopathy : A review paper with practical recommendations on behalf of the European Society of Cardiovascular Radiology (ESCR). Int J Cardiovasc Imaging. 2023;39(11):2221-35. [Crossref]
  10. EMA. Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 3-6 May 2021 Internet Document : 7 May 2021.
  11. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1601-9. [Crossref]
  12. Salerno M, Kwong RY. CMR in the Era of COVID-19: Evaluation of Myocarditis in the Subacute Phase. JACC: Cardiovasc Imaging. 2020;13(11): 2340-2. [Crossref]
  13. Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem infammatory syndrome in children in New York State. N Engl J Med. 2020;383(4):347-58. [Crossref]
  14. Feldstein LR, Tenforde MW, Friedman KG, Newhams M, Rose EB, Dapul H, et al. Characteristics and outcomes of US children and adolescents with multisystem infammatory syndrome in children (MIS-C) compared with severe acute COVID-19. JAMA. 2021;325(11):1074-87. [Crossref]
  15. Capone CA, Misra N, Ganigara M, Epstein S, Rajan S, Acharya SS, et al. Six month follow-up of patients with multi-system infammatory syndrome in children. Pediatrics. 2021;148(4):e2021050973. [Crossref]
  16. Benvenuto S, Simonini G, Paolera SD, Rumeileh SA, Mastrolia MV, Manerba A. Cardiac MRI in midterm follow up of MISC: a multicenter study European Journal of Pediatrics. 2023;182:845-54. [Crossref]
  17. Rowley AH. Understanding SARS-CoV-2-related multisystem infammatory syndrome in children. Nat Rev Immunol. 2020;20(8):453-4. [Crossref]
  18. Bratis K, Hachmann P, Child N, Krasemann T, Hussain T, Mavrogeni S, et al. Cardiac magnetic resonance feature tracking in Kawasaki disease convalescence. Ann Pediatr Cardiol. 2017;10(1):18-25. [Crossref]
  19. Gargano JW, Wallace M, Hadler SC, Langley G, Su JR, Oster ME, et al. Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the advisory committee on immunization practices - United States, June 2021. MMWR Morb Mortal Wkly Rep. 2021;70:977-82. [Crossref]
  20. Ozen S, Gül AEK, Gülhan B, Özbülbül NI, Yüksek SK, Terin H, et al. Admission and follow-up cardiac magnetic resonance imaging findings in BNT162b2 Vaccine-Related myocarditis in adolescents. Infect Dis 2023;55(3):199-206. [Crossref]
  21. Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar-Hari M, et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med. 2022;28(2):410-22. [Crossref]
  22. Heymans S, Cooper LT. Myocarditis after COVID-19 mRNA vaccination:clinical observations and potential mechanisms. Nat Rev Cardiol. 2022;19(2):75-7. [Crossref]
  23. Amodio D, Manno EC, Cotugno N, Santilli V, Franceschini A, Perrone MA, et al. Relapsing myocarditis following initial recovery of post COVID-19 vaccination in two adolescent males - Case reports. Vaccine X. 2023;14:100318. [Crossref]
  24. Sanchez Tijmes F, Thavendiranathan P, Udell JA, Seidman MA, Hanneman K. Cardiac MRI Assessment of Nonischemic Myocardial Inflammation: State of the Art Review and Update on Myocarditis Associated with COVID-19 Vaccination. Radiol Cardiothorac Imaging. 2021;3(6):e210252. [Crossref]
  25. Hanneman K, Iwanochko RM, Thavendiranathan P. Evolution ofLymphadenopathy at PET/MRI after COVID-19 Vaccination. Radiology. 2021;299(3):E282. [Crossref]
  26. Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, et al. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol. 2009; 53:1475-87. [Crossref]
  27. Ferreira VM, Schulz-Menger J, Holmvang G, Kramer CM, Carbone I, Sechtem U, et al. Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations. J Am Coll Cardiol. 2018;72(24):3158-76. [Crossref]
  28. Ammirati E, Cipriani M, Lilliu M, Sormani P2, Varrenti M, Raineri C, et al. Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulminant Acute Myocarditis. Circulation. 2017;136(6):529-45. [Crossref]
  29. Lagan J, Schmitt M, Miller CA. Clinical applications of multi-parametric CMR in myocarditis and systemic inflammatory diseases. Int J Cardiovasc Imaging. 2018;34(1):35-54. [Crossref]
  30. Radunski UK, Lund GK, Stehning C, Schnackenburg B, Bohnen S, Adam G, et al. CMR in patients with severe myocarditis diagnostic value of quantitative tissue markers including extracellular volume imaging. JACC. 2014; 7(7):557-75. [Crossref]
  31. Hinojar R, Foote L, Ucar EA, Jackson T, Jabbour A, Yu CY, et al. Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis a proposed diagnostic algorithm using CMR. JACC. 2015; 8(1):37-46. [Crossref]
  32. Monney PA, Sekhri N, Burchell T, Knight C, Davies C, Deaner A, et al. Acute myocarditis presenting as acute coronary syndrome: role of early cardiac magnetic resonance in its diagnosis. Heart. 2011;97(16):1312-8. [Crossref]
  33. Verbrugge FH, Bertrand PB, Willems E, Gielen E, Mullens W, Giri S, et al. Global myocardial oedema in advanced decompensated heart failure. Eur Heart J Cardiovasc Imaging. 2017;18(7):787-94. [Crossref]
  34. Thavendiranathan P, Walls M, Gir S, Verhaert D, Rajagopalan S, Moore S, et al. Improved detection of myocardial involvement in acute inflammatory cardiomyopathies using T2 mapping. Circ Cardiovasc Imaging. 2012;5(1):102-10. [Crossref]
  35. Perea RJ, Ortiz-Perez JT, Sole M, Cibeira MT, de Caralt TM, Prat-Gonzalez S, et al. T1 mapping: characterisation of myocardial interstitial space. Insights Imaging. 2015;6(2):189-202. [Crossref]
  36. Luetkens JA, Homsi R, Sprinkart AM, Doerner J, Dabir D, Kuetting DL, et al. Incremental value of quantitative CMR including parametric mapping for the diagnosis of acute myocarditis. Eur Heart J Cardiovasc Imaging. 2016; 17(2):154-61. [Crossref]
  37. Tahir E, Sinn M, Bohnen S, Avanesov M, Säring D, Stehning C, et al. Acute versus chronic myocardial infarction: diagnostic accuracy of quantitative native T1 and T2 mapping versus assessment of edema on standard T2-weighted cardiovascular MR images for differentiation. Radiology. 2017;285(1):83-91. [Crossref]
  38. Kim RJ, Shah DJ, Judd RM.How we perform delayed enhancement imaging. J Cardiovasc Magn Reson. 2003;5(3):505-14. [Crossref]
  39. Mahrholdt H, Wagner A, Deluigi CC, Kispert E, Hager S, Meinhardt G,et al. Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation. 2006;114(15):1581-90. [Crossref]
  40. di Bella G, Camastra G, Monti L, Dellegrottaglie S, Piaggi P, Moro C, et al. Left and right ventricular morphology, function and late gadolinium enhancement extent and localization change with different clinical presentation of acute myocarditis data from the ITAlian multicenter study on MYocarditis (ITAMY). J Cardiovasc Med (Hagerstown). 2017;18(11):881-7. [Crossref]