title: Myocardial Inflammation-Are We There Yet?
abstract: Several exogenous or endogenous factors can lead to inflammatory heart disease. Beside infectious myocarditis, other systemic inflammatory disorders such as sarcoidosis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Churg-Strauss syndrome, and rheumatoid arthritis can affect the myocardium. Myocardial inflammation may have a major impact on the outcome of these patients, resulting in sudden cardiac death, severe arrhythmias, or end-stage heart failure. The current gold standard for definite confirmation of inflammatory heart disease is endomyocardial biopsy (EMB), but is invasive and suffers low sensitivity and specificity due to sampling errors. Thus, non-invasive methods for detecting the extent and changes over time of the inflammatory myocardial disease are needed. Cardiac magnetic resonance (CMR) is such a non-invasive method. We will describe and discuss different approaches for CMR assessment of inflammatory myocardial disease including early gadolinium enhancement (EGE), T2-weighted imaging, late gadolinium enhancement (LGE), the newer mapping proton relaxation techniques (T1 pre-contrast, T1 post-contrast, T2 mapping), and the hybrid PET/MRI technique.
authors.affiliation: Division of Cardiology, Robert Bosch Medical Center, Auerbachstrasse 110, 70376 Stuttgart, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Greulich
authors.affiliation: Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU UK.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Ferreira
authors.affiliation: Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU UK.
authors.forename: Erica
authors.initials: E
authors.lastname: Dall'Armellina
authors.affiliation: Division of Cardiology, Robert Bosch Medical Center, Auerbachstrasse 110, 70376 Stuttgart, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Mahrholdt
keywords: Cardiovascular magnetic resonance; Edema; Gadolinium; Mapping; Myocardial inflammation; Tissue characterization