Antimyosin scintigraphy for detection of myocarditis. Scintigraphic follow-up.
To examine the value of antimyosin-indium 111 imaging in relation to endomyocardial biopsy in patients with suspected myocarditis, as well as the natural evolution of abnormal findings on the antimyosin scan, 12 patients with suspected myocarditis underwent endomyocardial biopsy and antimyosin scan. The heart-to-lung ratio (H/L) was used to quantify the antimyosin scan. All 12 patients had abnormal results on the scan (H/L, 1.7 to 2.9; mean, 2.1 +/- 0.3); 8 of the 12 patients also had a diagnostic endomyocardial biopsy. In four patients with abnormal findings on antimyosin scan and normal findings on biopsy, the H/L ratio did not differ from eight patients with abnormal findings on antimyosin scan and a diagnostic biopsy; also, the ejection fraction did not differ between the two groups. One patient died, and 8 patients had a repeat antimyosin scan within 2 months after the initial study. The H/L ratio returned to normal in two out of three patients with normal results on biopsy and in three out of five patients with a diagnostic biopsy; the ejection fraction improved by 8 percent or more in one out of three patients with a nondiagnostic biopsy and in two out of five patients with a biopsy diagnostic for myocarditis. We conclude that the antimyosin scan is more frequently diagnostic than biopsy in suspected myocarditis. Patients with abnormal results on antimyosin scan and a nondiagnostic biopsy, as well as those with abnormal results on antimyosin scan and a diagnostic biopsy, tend to return to normal results on scan within 2 months and improve their ejection fraction.
Lekakis
J
J
Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.
Nanas
J
J
Moustafellou
A
A
Kostamis
P
P
Moulopoulos
S
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D009218:Myosins / Q000276:immunology*; D009942:Organometallic Compounds; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013997:Time Factors
D000911:Antibodies, Monoclonal; D007205:Indium Radioisotopes; D009942:Organometallic Compounds; C058899:imciromab pentetate; D009218:Myosins