Document Detail

Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology.
MedLine Citation:
PMID:  14993139     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Myocarditis can occasionally lead to sudden death and may progress to dilated cardiomyopathy in up to 10% of patients. Because the initial onset is difficult to recognize clinically and the diagnostic tools available are unsatisfactory, new strategies to diagnose myocarditis are needed. METHODS AND RESULTS: Cardiovascular MR imaging (CMR) was performed in 32 patients who were diagnosed with myocarditis by clinical criteria. To determine whether CMR visualizes areas of active myocarditis, endomyocardial biopsy was taken from the region of contrast enhancement and submitted to histopathologic analysis. Follow-up was performed 3 month later. Contrast enhancement was present in 28 patients (88%) and was usually seen with one or several foci in the myocardium. Foci were most frequently located in the lateral free wall. In the 21 patients in whom biopsy was obtained from the region of contrast enhancement, histopathologic analysis revealed active myocarditis in 19 patients (parvovirus B19, n=12; human herpes virus type 6 [HHV 6], n=5). Conversely, in the remaining 11 patients, in whom biopsy could not be taken from the region of contrast enhancement, active myocarditis was found in one case only (HHV6). At follow-up, the area of contrast enhancement decreased from 9+/-11% to 3+/-4% of left ventricular mass as the left ventricular ejection fraction improved from 47+/-19% to 60+/-10%. CONCLUSIONS: Contrast enhancement is a frequent finding in the clinical setting of suspected myocarditis and is associated with active inflammation defined by histopathology. Myocarditis occurs predominantly in the lateral free wall. Contrast CMR is a valuable tool for the evaluation and monitoring of inflammatory heart disease.
Heiko Mahrholdt; Christine Goedecke; Anja Wagner; Gabriel Meinhardt; Anasthasios Athanasiadis; Holger Vogelsberg; Peter Fritz; Karin Klingel; Reinhard Kandolf; Udo Sechtem
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-03-01
Journal Detail:
Title:  Circulation     Volume:  109     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-03-16     Completed Date:  2004-06-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1250-8     Citation Subset:  AIM; IM    
Division of Cardiology, Robert Bosch Medical Center, Stuttgart, Germany.
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MeSH Terms
Cardiomyopathy, Hypertrophic / diagnosis
Contrast Media
Disease Progression
Endocardium / pathology
Gadolinium DTPA
Heart Ventricles / pathology
Herpesvirus 6, Human / isolation & purification
Incidental Findings
Magnetic Resonance Imaging*
Magnetic Resonance Imaging, Cine
Middle Aged
Myocarditis / complications,  diagnosis*,  pathology,  virology
Parvoviridae Infections / diagnosis,  pathology,  virology
Parvovirus B19, Human / isolation & purification
Roseolovirus Infections / diagnosis,  pathology,  virology
Single-Blind Method
Stroke Volume
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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