[Show abstract][Hide abstract] ABSTRACT: To evaluate myocarditis in a pediatric population using cardiovascular magnetic resonance (CMR) and endomyocardial biopsy.
Twenty suspected for myocarditis patients aged 8-16years and 20 controls were evaluated. CMR was performed using STIR T2-weighted (T2W), early T1-weighted (EGE) and late gadolinium-enhanced images (LGE). Immunohistologic and polymerase chain reaction (PCR) analysis of myocardial specimens were employed in 8/16, who fulfilled the criteria for myocarditis according to clinical and CMR findings.
Typical clinical, ECG and echocardiographic presentation were identified in 10/16. Troponine I was positive only in 3/16 patients. T2 and EGE in myocarditis were increased compared to controls (2.35±0.5 vs. 1.57±0.13, p<0.001 and 8.5±3 vs. 3.59±0.08, p<0.001, respectively). LGE was found only in 10/16 patients. Endomyocardial biopsy, performed in 8/16 patients with positive CMR, showed positive immunohistology in 2/8 and presence of viral genomes in 6/8 (Herpes, Parvo B19 and Epstein-Barr). Left ventricular ejection fraction (LVEF) was significantly decreased compared to controls (49.6±14.8 vs. 64±0.2, p<0.001). After 6months, CMR showed normalization of T2, EGE and decreased/or absent LGE. LVEF was normal in all, except two, who remained with low LVEF but in a stable clinical condition.
In a small Greek pediatric population with myocarditis, CMR proved useful for the detection of myocarditis, especially in those with negative troponine and mild clinical presentation.
International journal of cardiology 05/2011; 160(3):192-5. DOI:10.1016/j.ijcard.2011.04.019 · 4.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abnormal cardiovascular magnetic resonance findings were found in a patient with microscopic polyangiitis and a patient with Kawasaki disease that presented without overt clinical cardiovascular manifestations.
International journal of cardiology 02/2009; 141(1):e17-9. DOI:10.1016/j.ijcard.2008.11.133 · 4.04 Impact Factor