MRI-based evidence for myocardial involvement in women with hypereosinophilic syndrome.
OBJECTIVE
The aim of the study was to assess the presence and spectrum of cardiac abnormalities identified by cardiac magnetic resonance (CMR) in women with hypereosinophilic syndrome (HES) of undefined etiology, who present with normal electrocardiography (ECG) and transthoracic echocardiography (TTE) and no history of heart disease.


METHODS
Ten women (mean age, 48 ± 14 years) with HES of undefined etiology, normal ECG and TTE, and no history of heart disease underwent CMR.


RESULTS
CMR showed cardiac abnormalities in 6 subjects. Five patients had nonischemic late gadolinium enhancement (LGE) lesions within the left ventricular (LV) myocardium, and 3 patients demonstrated CMR evidence of myocardial inflammation. The LV ejection fraction was 68.5 ± 5.7%, and the end-diastolic volume index was 62.7 ± 14.7 mL/m(2). The maximum measured blood eosinophil count correlated with LVLGE volume (r = 0.80, P = 0.006) and was 11374 ± 6242 cells/μL and 4114 ± 2972 cells/μL (P = 0.047) in patients with and without LGE lesions, respectively. The actual blood eosinophil count in subjects with and without CMR evidence of myocarditis was 1058 ± 520 cells/μL and 354 ± 377 cells/μL (P = 0.04), respectively.


CONCLUSIONS
Despite normal ECG, TTE, and absence of history of heart disease, women with HES of unknown etiology frequently demonstrate cardiac abnormalities on CMR, the presence and extent of which are related to blood eosinophil count.
Department of Medicine, Jagiellonian University Medical College ul. Skawinska 8, 31–066 Kraków, Poland; Department of Radiology and Imaging Diagnostics, John Paul II Hospital, Kraków, Poland; Center for Heart Disease, Clinical Military Hospital, Wrocław, Poland. miszalt@mp.pl
Tomasz
T
Miszalski-Jamka
Wojciech
W
Szczeklik
Krzysztof
K
Karwat
Barbara
B
Sokołowska
Jolanta
J
Gąsior
Małgorzata
M
Rucińska
Wojciech
W
Mazur
Aleksander
A
Skotnicki
Dean J
DJ
Kereiakes
Małgorzata
M
Urbańczyk
Przemysław
P
Jaźwiec
Jacek
J
Musiał
D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D004804:Eosinophils / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D019786:Gadolinium DTPA; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000097:blood / Q000150:complications*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology; D055815:Young Adult
D003287:Contrast Media; D005682:Gadolinium; D019786:Gadolinium DTPA